Helen Martin: Mental Health Act needs care

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THE Dowager Duchess of Hamilton’s tragic story of how the Duke voluntarily went to hospital to have his medication for dementia checked, and was then sectioned under Scotland’s Mental Health Act for 28 days, was very moving.

In simple words she painted a graphic picture of him calling her name, later begging to go home, and subsequently being discharged only once she had pledged to provide 24-hour care for him at home.

She believes the experience hastened his death soon after, and understandably she feels “sectioning” should require more than the orders of just a doctor and a mental health officer.

Now, four years later, she makes the point that if it can happen to the Duke of Hamilton, whose family can afford to provide that conditional care, what chance does “Joe Bloggs” have?

She’s a gracious lady with the best intentions based on her own experience and clearly has empathy with those less financially fortunate who might find themselves in her shoes. Many will agree with her.

There are however – and this might be a disturbing truth – other people who wish their loved ones had been sectioned, or who, unlike the Dowager Duchess, want someone to make that decision for them.

Mental illness, or any form of dementia, varies so much it ranges from violence and frightening behaviour to those who simply need 24-hour care. Every case is different and many will be so completely different from the Duke’s as to bear no similarity at all.

Years ago, one of my closest friends knew that her son was mentally ill. Doctors, psychiatrists and specialists pondered several possible diagnoses without coming to any firm conclusion. He had been sectioned twice, but always short term, because of violent or erratic behaviour. Being well above the age of consent and still living at home, he was responsible for taking his own medication. One night a minor domestic argument over him using the car resulted in him murdering his father and almost murdering his mother. Like the Dowager Duchess, I am no expert. But I could argue in that particular case, that longer-term sectioning should have been quicker and easier.

Then there are those who do not have the money, influence or wherewithal to employ 24-hour carers or the resilience, stamina and capability to give that care themselves but keep trying, and failing, to no-one’s benefit. I admit I know the sense of relief when the authorities take over, make the decision, and section an elderly relative with dementia for their own protection.

I don’t believe any doctors or mental health officers invoke the sectioning clause of the Mental Health Act lightly. And in such a complex area, perhaps the legislation will never be perfect or work perfectly for each case. It is, after all, a decision that often has to be taken in emergency circumstances.

But if it is tightened up, prolonged, or made more difficult to execute, there’s the risk that as many people will be hurt as helped.

A “limited review” of the Act is due next year, hopefully after extensive research and consultation and not based on the experience, however honest, earnest and heart-felt, of one 
aristocratic lady.