Reform of the Mental Health Act

The Mental Health Act 1959 followed a groundbreaking Royal Commission and marked a transition from legalistic forms to paternalism. Mental health professionals were given wide latitude to act in the health interests of people with mental disorders. The Mental Health Act 1983 (MHA) curtailed some of these powers and strengthened patients' rights against paternalistic intrusion. The 1990s has seen yet another shift; ‘community care’ has frightened many into a preoccupation with ‘public safety’ and seeking means of exerting more control over patients, especially to ensure their compliance with treatment in the community (Department of Health, 1998, 1999). Such swings of policy remind us that the prescription of involuntary treatment is primarily a social matter and only weakly related to the epidemiology or clinical features of mental disorder.