Section 3 — Meaning of "mental Disorder" in the 1984 Act
Part of Mental Health (Public Safety and Appeals) (Scotland) Bill: Stage 2 – in the Scottish Parliament at 4:30 pm on 8th September 1999.
Michael Matheson Scottish National Party 4:30 pm, 8th September 1999
Section 3 of the bill seeks to widen the definition of mental disorder in the Mental Health (Scotland) Act 1984 to include personality disorder. The 1984 act states that "'mental disorder' means mental illness or mental handicap, however caused or manifested".
I believe that the definition in the bill is too wide-ranging and could have unacceptable consequences. In the Parliament's debate last week, members throughout the chamber raised the issue of how to define personality disorder; they were concerned that the bill would classify personality disorder as a mental illness. Unfortunately, ministers failed adequately to deal with those concerns. Amendment 28 would address some of those issues by providing greater clarity in defining personality disorder.
In recent years, psychiatric thinking on personality disorders has changed; as a result of that change, the 1984 act is now clearly inadequate. However, the bill fails to take account of the new thinking. That was a concern for Richard Simpson in last week's debate. He stated:
"I have no difficulty with the definition of personality disorder as a mental disorder, but psychiatrists have great difficulty with it being placed in the category of mental illness, as is proposed in the bill."-[Official Report, 2 September 1999; Vol 1, c 117.]
I see that Dr Simpson-who is, I understand, a psychiatrist-is here today and can stand by his remarks. The purpose of amendment 28 is to bring the bill into line with the psychiatric thinking that Dr Simpson highlighted last week. I hope that, in the light of his statement, he will join us in agreeing to the amendment.
Dr Jim Dyer, for whom I have considerable respect, having been a student in acute psychiatry under him at the Royal Edinburgh hospital, is the director of the Mental Welfare Commission for Scotland. He echoes the concerns about the wide definition of personality disorder in the bill; he, too, wants the bill to be brought into line with current medical thinking. He has gone on record and has written to all members of the Scottish Parliament to indicate his concern on this issue. Given his public statement and his statutory responsibility to highlight such issues to the Scottish Executive and the responsible ministers, I hope that the Executive will recognise that this amendment seeks to address the same concerns as those highlighted by the Mental Welfare Commission for Scotland.
Amendment 28 also seeks to focus the bill on those individuals with a particular type of personality disorder who are a marked risk to society. In last week's debate, several members expressed the concern that the bill fails to take account of the fact that the majority of those with such a personality disorder pose no risk to society. Dennis Canavan remarked that if we did not tighten up the bill's definition of personality disorder, this chamber could be rather empty. In my view, it is likely that the press benches will be even emptier. [Laughter.] I am sure that I will get good copy for that tomorrow.
Even the Government agrees that many individuals with a personality disorder pose no risk to society. The Government paper, "Managing Dangerous People With Severe Personality Disorder", which was published in July, states that "the overwhelming majority do not pose a risk to the public and live reasonably ordered, crime free, lives".
The Mental Welfare Commission for Scotland and the Law Society of Scotland have highlighted that point, but the bill fails to make the matter clear. I understand that the commission has written to ministers to inform them of its concerns.
The amendment would enhance the bill in three ways. First, it would bring the bill into line with current psychiatric thinking and clarify the view that personality disorder is not a mental illness. Secondly, it would ensure that the bill is precisely focused on those individuals with a personality disorder who pose most risk to society. Thirdly, when an organisation such as the Mental Welfare Commission for Scotland raises concerns about the bill, it should be listened to-the amendment goes some way to addressing those concerns.
Jim Wallace made it clear that he had given the Mental Welfare Commission the responsibility to review service provision in the state hospital at Carstairs because it was the appropriate body. The commission, which Iain Gray said knew most about this issue, has expressed its concerns, which is why this amendment has been lodged.
I, therefore move amendment 28.