English Mental Health Reform: Lessons from Ontario?
by Peter Bartlett*
Reforms in areas related to mental disability are under debate in England to an extent unprecedented for almost half a century. The Law Commission’s proposals on incapacity, following further consultation from the Lord Chancellor’s Department, have now largely been accepted in principle by the government for legislative enactment at some time in the undetermined future.(1) A joint green paper from the Home Office and the Department of Health has established a policy agenda concerning the governance of people with serious personality disorders.(2) Proposals by an expert committee chaired by Professor Genevra Richardson on mental health reform have likewise been followed up by a government green paper,(3) and the two green papers have in turn resulted in a joint white paper on reform of the Mental Health Act 1983.(4) All this takes place as the Human Rights Act 1998 takes effect, with its guarantees relating to liberty and security of the person, standards for hearings, respect for private and family life, and protection from inhuman or degrading treatment. Throughout the development of the reforms, a number of similar themes have recurred, involving civil rights, the provision of appropriate legal processes, anti-discrimination, the respect for people with capacity, the extension of controls into the community, and the safety both of people with mental disabilities and of the public as a whole.
At least in the public arena, most of the debate has focussed on the English situation. The premise of this paper is that the situation in the rest of the world may have something to teach us. The paper examines the law of Ontario. While it focuses primarily on those issues related to the Richardson Report and its subsequent government response, Ontario legislation divides issues somewhat differently to English law, and thus overlap with the other reform proposals is inevitable.
Footnotes:
*Senior Lecturer in Law, University of Nottingham. Barrister and solicitor (Ontario). Address for correspondence: School of Law, University of Nottingham, Nottingham, NG7 2RD, UK, or peter.bartlett@nottingham.ac.uk My thanks to Mona Gupta and Carla McKague, who have provided helpful comments on a draft of this article. Errors, of course, remain my responsibility.
(1) Law Commission, Mental Incapacity, Law Com No.231 (London: HMSO, 1995); Lord Chancellor’s Department, Making Decisions, Cm. 4465 (London:TSO, 1999).
(2) ‘Managing Dangerous People with Severe Personality Disorder - proposals for policy development’. (London: TSO, 1999).
(3) Expert Committee, ‘Review of the Mental Health Act 1983’, chair: G. Richardson, (London: Department of Health, 1999); Department of Health and the Welsh Office, ‘Reform of the Mental Health Act 1983: Proposals for Consultation’ (London: TSO, 1999).
(4) Department of Health and the Home Office, ‘Reforming the Mental Health Act’, 2 vols., Cm 5016-1 (London: TSO, 2000).
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