Challenging contemporary mental health policy: time to assuage the coercion?
BACKGROUND
In the United Kingdom (UK) and elsewhere throughout the world, the policy and legal frameworks that surround the provision of mental health care are becoming increasingly coercive. For example, emerging mental health policy in the UK includes a commitment to the introduction of compulsory treatment in the community.


OBJECTIVE
In this paper, our aims are: to explore the context in which this more coercive mental health policy has arisen in the UK; to challenge the assumptions and the evidence that lie behind the introduction of proposed new mental health policies; and to consider the impact that a more coercive policy is likely to have on the practice of mental health nursing.


CONCLUSIONS
In the UK, representatives of central government have declared that 'care in the community has failed'. This view has been reinforced by media representations of mental health issues. Policy documents have drawn attention to the risks posed by people with mental illnesses. Correspondingly, proposed initiatives emphasize the need to more closely 'manage' people with mental health problems, and set out a new legislative and policy framework to achieve this. We question the assumptions and evidence that underlie these planned new developments. We argue that, contrary to government assertions, there is no unequivocal evidence that 'community care' has failed. We observe, too, that people with mental health difficulties are often amongst the most vulnerable members of society. Finally, we consider the impact that a more coercive policy framework will have on the work of mental health nurses, and argue that the shift towards a more 'controlling' role is likely to run counter to what many nurses see as the 'core' of their work.
Hannigan
Ben
B
School of Nursing and Midwifery Studies, University of Wales College of Medicine, Caerleon Education Centre, Caerleon, Newport, UK. hanniganb@cardiff.ac.uk
Cutcliffe
John
J
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000639:trends; D003156:Community Mental Health Services / Q000458:organization & administration*; D003659:Decision Making, Organizational; D006291:Health Policy / Q000331:legislation & jurisprudence / Q000639:trends; D006801:Humans; D007587:Job Description; D008402:Mass Media; D008603:Mental Health; D008605:Mental Health Services / Q000458:organization & administration*; D024802:Nurse's Role; D009740:Nursing Staff / Q000458:organization & administration / Q000523:psychology; D010344:Patient Advocacy / Q000331:legislation & jurisprudence; D011568:Psychiatric Nursing / Q000458:organization & administration*; D006113:United Kingdom