Mental Health Act Language

Often mental health services, particularly inpatient teams, use the language of the mental health act when discussing patients, not just the detained ones. I think this is unhelpful because a) it is misleading, but b) because it reflects a mindset that detention and the restriction of patients’ liberties is the norm, when in fact it is the exception. Even if the majority of patients are detained, we should still maintain the attitude that detention is the departure from normal practice in the extreme situations that the MHA is intended to cover.

As examples, we never hear of patients (non-detained) saying that they are going home for the weekend – instead it is always that x is requesting leave and is that OK. We know that it is not our decision and that x can go whenever he likes, but the default perspective that we are in charge of / responsible for other people when we are actually just offering a service they can take or leave I think is damaging. It is worse still if x really thinks he has to ask, and not just that it is being reported in the language of the MHA.

Also we hear a lot in discussions of non-detained patients that “well we can’t detain him” as if there is an air of regret around that! It scares me that we have to think on our feet about ways to cope with the fact that we can’t just force the person to comply. That somebody is undetainable is a good thing, in my opinion, and that people who are detainable are so for reasons that are awful for them (that is, they need detention in their own best interests for specific reasons, that they are horribly ill and pose a risk to themselves or others.) If we regret that a person may not be detained, that suggests that we are losing the ability or the willingness to work with people collaboratively and that would be terrible.

I would be the first to roll my eyes at the political over-correctness of identity politics, for example levering in the word “people” after politically sensitive adjectives makes my flesh creep, however my concern here is that language use not only reflects, but influences our mind-set and attitude towards the people we work with, most powerfully in the way trainees, students and new staff absorb assumptions that it appears from our language that we make.

Jim CromwellComment