Act gives ‘far too much power’ to psychiatrists

By Jennifer Hough

Tuesday, July 20, 2010

DOCTORS need to sit down with people who feel they have been abused and harmed in the mental health system and see how it can be changed for the better, the clinical director of the West Cork mental health service has said.

Dr Pat Bracken, a consultant psychiatrist who has worked in the field of mental health for 27 years, said it was time for society to engage in an open and frank debate about how mental illness is treated.

Dr Bracken said the Mental Health Act puts "far too much power" in the hands of psychiatrists and serves to endorse the culture of "medical paternalism".

"The culture in this country has changed significantly over the past 10 years and people are questioning professionals more and more. We have seen what happens when you lock people away, and we are a lot more sensitive to the danger of institutions," he said.

Dr Bracken, who advocates that electro compulsive therapy (electric shock treatment) should not be used without a patient’s consent, questioned whether psychiatrists were the best people to have power over an involuntarily patient.

"Someone needs to have the power to make decisions for a patient who might not be able to, but I would question whether a psychiatrist is the best person – or even someone in the medical profession as there is something fundamentally different about a mental illness."

Dr Bracken said questions needed to be asked in relation to the over-use of antidepressants.

"The use of psychotropic drugs has gone up massively, but there is no evidence to suggest the quality of life for people has gone up accordingly."

Dr Bracken said professionals working in the area of mental health needed to open up to a global trend whereby service users and former patients are speaking out and challenging the system.

One such campaigner is Cork-based John McCarthy. Mr McCarthy advocates on behalf of people who are being detained in psychiatric units.

Mr McCarthy said he knows of people who have been locked up all their lives and that he had often been denied access to patients he wanted to visit. "These are public hospitals, why can a member of the public not go in and visit people?"

A spokesperson for the HSE said the aim of the mental health services is to work in a collaborative way with patients and their families to ensure the best outcome possible for people who need mental health services.

"All patients detained under the Mental Health Act have access to independent legal advice. Their detention under the mental health act is reviewed at regular intervals by an independent mental health review tribunal and the tribunal has the power to end the patient’s detention," a spokesperson said.