Mental health tribunals need more powers to care for people outside hospitals, says judge

A specialist judge involved in an independent review of mental health legislation has said tribunals need more powers to help people to be cared for outside hospitals.

Anselm Eldergill, a judge in the Court of Protection, said evidence suggests that mental health tribunals have become more risk-averse and interpret rules relating to hospital discharge more conservatively than in the past.

His comments came in the wake of a report following an independent review of the 1983 Mental Health Act.

Judge Eldergill (pictured), who chaired the review’s tribunal working group, said the report represents a missed opportunity to develop a framework for tribunals which takes account of shortcomings.

The report, published on Thursday, said major new investment was needed to improve some of the most “dilapidated” estates in the NHS and provide more community care for the sickest and most vulnerable mental health patients.

It said compulsory treatment must be a last resort and more care should be provided in the community before people reach a crisis point and need to be detained.

Judge Eldergill said the report had not adopted recommendations made by the tribunal working group, and that he does not support the “tribunal part” of it.

“The evidence overall suggests that tribunals have become more risk-averse and interpret the unchanged statutory criteria for discharge much more conservatively than in the past,” he said.

“It was also clear to the tribunal working group that tribunals need a much wider range of powers to help people suffering from mental ill-health to be discharged from hospital and to be cared for in the least restrictive manner possible.”

He said the working group recommended legislative changes but noted the report has not adopted most of those recommendations.

“In this respect the report represents a missed opportunity to develop a framework for tribunals which takes account of the shortcomings identified by practitioners since the Mental Health Act came into force 35 years ago,” he said.

“Indeed, the tribunal part of the independent review report could not be weaker and in several respects the safeguards against unjustified detention seem to me to be weaker than at present.”

He added: “Although I chaired the independent review’s tribunal working group, and continue to support what the group recommended, I cannot, I am afraid, support the tribunal part of the report.

“Over the coming months it will be important to continue to press the case for what the working group collectively recommended.”

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