Lessons from the Mental Health Act Commission for England and Wales: The Limitations of Legalism-Plus-Safeguards

Abstract

AbstractIn 2009, the Mental Health Act Commission for England and Wales was closed down and its functions subsumed in separate organisations in the two countries. Its final biennial report, issued that year, focused on coercion and consent. This article uses some aspects of the report to discuss the implications of lawful psychiatric coercion being predicted by social group membership (correlated with race, age and gender). The work of the Commission furnished useful information in this regard, but its framework for data collection could not, and so did not, illuminate a more established picture of the class gradient in mental health problems. With the latter literature in mind, material adversity may explain the racial patterning of psychiatric populations coercively detained. However, normative aspects of risk-taking in the community and in hospital may better predict the findings on age and gender. The article concludes by querying the ameliorative impact of government appointed ‘visitorial’ bodies. Legalism-plus-safeguards is a questionable basis for meaningfully bringing discriminatory powers to book, or for reversing the differential impact of pathogenic social forces.