Anna Dixon

I am no expert on mental health law, but I do have decades of experience in the health and care sector, and my sister is a psychiatrist. I know that the decision to detain someone with severe mental illness is never taken lightly, and that psychiatrists must weigh up a range of factors and information to come to a final decision. I tabled amendments 43, 44 and 45 and new clause 34 after a number of conversations with the Royal College of Psychiatrists, which has expressed concern about the wording used in the detention criteria. Taken together, the purpose of my amendments is to ensure that the detention criteria are aligned with good clinical practice. It is important that they are reflected in the primary legislation, rather than simply relying on a code of practice. They would remove from the detention criteria mention of the terms “likelihood” or “may be caused” to allow psychiatrists to make a straightforward, holistic assessment of individual risk in the context of significant mental disorder. The risk is that “likelihood” suggests that it is possible for clinicians to predict serious harms such as violence or suicide when it is not possible to do so, while the idea of causation neglects the fact that complex background conditions can be the genesis of a harm. There is a risk, too, that the language may lead to preventive detention—more detention, not less. It is always easier with hindsight, when unexpected harms have happened, to oversimplify causation and ask, “Why was this person not detained?