More sinister than cuckoo

Jack Nicholson shot to fame in the 1975 film One Flew Over the Cuckoo’s Nest. He played the heroic rebel McMurphy who defied the Establishment. The mental hospital was itself a metaphor for state authorities. For many people Milos Forman’s film brought to light the cruel imprisonment of mentally ill people and the horrors of electro convulsive treatment (ECT). ECT is still being practised in the UK, by the way, and under the 2006 Mental Health Bill, enforcement of treatment, including medication, can go on even after patients are discharged from hospital, for unlimited periods of time. As McMurphy discovered, being a mental patient was worse than being in jail, because at least prisoners know how long their sentences will last.

More than thirty years on in the UK, psychiatrists and mental health practitioners have united in opposing the Bill presently going through the Report Stage in the House of Commons before it receives its Third Reading. Its provisions make it easier to detain people and force them to undertake treatment, whether or not they have committed a crime.

Late in May, five organisations representing 85% of Mental Health Staff suspended their membership from the Mental Health Alliance UK so that they could air their views independently on the Bill.

Last week the Commission for Racial Equality (CRE) condemned the Department of Health for “probably the worst” racial record of any Whitehall department and condemned the “manipulative practices” used to drive through the bill.

At the Royal College of Psychiatrists' Annual Conference in Edinburgh at the weekend, Professor Graham Thornicroft, of the Institute of Psychiatry at Kings College, London, said “… The last thing we need now is a mental health law that will make social exclusion even worse, especially for black people who feel coerced by the system”.

One out of five mental health patients in the UK are from ethnic minority backgrounds compared to one in ten in the population as a whole. African Caribbeans are 44% more likely to be sectioned, 29% more likely to be forcibly restrained, 50% more likely to be placed in seclusion and make up 30% of in-patients on medium secure psychiatric wards, despite having similar rates of mental illness as British white people.

Suman Fernando, an eminent psychiatrics professor at London Metropolitan University, recently turned down an OBE, in protest against the racist aspects of the Bill. In a letter to the prime minister and Gordon Brown rejecting the Honour, he wrote:

“Failure of mental health services to meet the needs of BME (Black Minority Ethnic) communities results from institutional racism and injustices are evident mostly in the experiences of black Caribbean people who are disproportionately sectioned and subjected to inappropriate – often damaging ‘care’.”

His rejection of the award was welcomed by Matilda MacAttram, director of Black Mental Health UK, and Alicia Spence of African Caribbean Community Initiative, who said: “He is standing up for those who have suffered and died within the mental health system…”.

Those with inside experience of treatment, like Miranda Morland of Bruised UK have also thanked Fernando, describing the Mental Health Bill as “draconian, with no consideration for the patient”. Morland points to the dangerous fusion of functions between the Home Office and the Department of Health:

“We are all terrified by the implications of the Mental Health Bill which has clearly come out of the Home Office and not the Department of Health. In the headlines this week we have found out that the government has secretly set up a VIP stalker squad to identify and detain terrorists and ‘OTHER’ individuals who pose a threat to prominent people. The unit staffed by police and psychiatrists, will have the power to detain suspects indefinitely using mental health laws.

“We always knew we were becoming a police state but it is happening almost over night and we have no way of stopping it, when these bully boy institutions work hand in hand. We need to wake up to the Agenda being set in this country before it is too late, and someone needs to remind the government that they work for us.”

Unfortunately, it’s also time to wake up to the fact that our interests, like those of mental health patients, are not on the government’s agenda.

Corinna Lotz, AWTW secretary