Risk versus need in revising the 1983 Mental Health Act: Conflicting claims, muddled policy

Abstract

The announcement in March 2006 of UK Government plans to modify the 1983 Mental Health Act is the latest attempt to update the laws by which individuals experiencing mental illness may be detained against their will in England and Wales. This proposal is the most recent in a long succession, dating back to 1998, whereby the Government originally set out to comprehensively revise existing legislation. The present paper analyses the policy process and substance surrounding these developments and the associated delays. An analytical framework combining claims-making and reception with Lindblom's ‘disjointed incrementalist’ conception of policy-making is developed and applied. While claims-making is implied within much of the literature, there is little explicit discussion of how claims based around risk and need are articulated and moreover received by policy-makers. Focusing on claims made by interest groups, the media, and parliamentary reports, the incorporation or preclusion of claims in government bills is explored. The indifference of Government to needs-based claims, yet that these claims have been made by such influential bodies as the Royal College of Psychiatrists, has resulted in rhetorical rather than substantive changes to previous proposals, the Government's latest, incrementalist approach, and the muddling of proposed legislation.

Keywords:

• Risk
• need
• mental health
• policy formation