There is one sharp distinction between psychiatry and all other forms of medical practice. In all the other branches of medicine, treatment is by consent. Although in modern psychiatric practice the bulk of treatment is by consent, there are still some people who are unable to give consent because of mental incapacity, and there are some people who are considered to be such a danger either to themselves or to others that they have to be treated without their consent. Until recently in England and Wales the care of the first group was governed by the Mental Capacity Act 2005 and the treatment of the second by the Mental Health Act 1983 (both of these, of course, consolidating and amending a huge body of legislation going back to some of the earliest recorded English laws). The new Mental Health Act 2007 has introduced further very substantial amendments to both of these acts. In particular it raised the difficult problem of coping with people whose mental state is such that they are a serious danger to themselves or others, but are not deemed to be treatable by current psychiatric methods. This is a very thorny topic. Detaining people because it is thought that they might commit crimes is a very serious threat to civil liberty, as also is compelling people to submit to treatment while remaining at large in the community – to say to someone “We will allow you to live in your own home on condition that you take these pills every day” could be the thin end of a nasty wedge.
The 2007 act is a very complex piece of legislation. The author of this guide describes it, rightly, as “a hotch‐potch of provisions … ” with “… the added vice of being exponentially more difficult to understand”. The 2005 act was notably straightforward. Even I could more or less understand it and could try to explain it to student social workers. Its replacement's clauses are “so labyrinthine and bureaucratic that those responsible for administering them are likely to take every opportunity to avoid using them”. These are strong words for a legal author to use, but they do mean that anyone concerned with mental health practice, or anyone concerned with advising and assisting people who are at risk of involvement with the mental health services, needs very careful legal guidance. The most widely‐used text until now has been the Mental Health Act Manual. This is currently in its 10th edition (Jones, 2006) with a supplement briefly covering the 2007 act. I understand that an 11th consolidated edition is in preparation (following which, libraries should discard earlier editions). The Lord Chancellor's office has issued notes on the effects of the 2007 act on mental capacity (Department of Constitutional Affairs, 2007) which are also useful. I also note that a new Blackstone's guide to the Mental Incapacity Act is in press, but have not seen it yet. I suspect that most psychiatrists, psychiatric social workers, mental health nurses, and, come to that, most general readers will find the manuals by Jones easier to understand and adequate for most general purposes. Complex pieces of legislation require complex texts however. I cannot pretend that non‐lawyers will find this book to be easy reading. It contains the full texts of both the previous acts, clearly indicating all the new provisions, amendments and deletions, with a careful and detailed analysis of their meanings by an expert public services lawyer. This book can be regarded as the definitive guide to current mental health law.
All public libraries are liable to face enquiries by people without legal training who need to find out about mental health law. It is difficult to recommend simple texts on complex topics. Assuming that a new edition of Jones comes out I would be inclined to recommend it as first choice, partly from sheer force of habit. This guide is well worth acquiring however. All major reference libraries should consider it for acquisition as a useful reference text on a topic of major social importance. Medical, nursing and social service libraries should obviously consider both. Legal libraries will obviously give this book the edge.
This review is entirely mine and represents my own views. I would take the opportunity however, to express thanks to John Gunn, emeritus professor of forensic psychiatry at the Institute of Psychiatry, for his never failing counsel and advice.
