ABSTRACT
In this chapter I explore what is meant by proper medical treatment in mental health law by focusing on the concept of ‘appropriate’ medical treatment in the Mental Health Act 1983, as amended by the Mental Health Act 2007 (the Act). The Act provides a framework for compulsory admission and treatment in hospital and, in some circumstances, coercive treatment in the community. It introduced an ‘availability’ of appropriate treatment test in the admission criteria. This test has proved controversial, particularly in its application to patients with a personality disorder. I examine what these terms mean, how they have been interpreted by the judiciary, and the breadth of the concept of medical treatment in section 63 of the Act. In the context of mental health, the courts have moved well beyond core treatment, such as medication or psychotherapy. As a consequence, the concept of medical treatment for mental disorder is extremely broad and highly subjective. There is also a lack of clarity about the appropriateness of such treatment. This raises important questions about the primary function of mental health law, and about what is ‘appropriate’ or ‘proper’ medical treatment. My discussion will lead on to exploring the changing nature of the professional roles and expanding expertise in diagnosis and treatment. This latter shift lies in contrast to other areas of medical practice, where there has, perhaps, been greater reluctance to dilute the traditional dominance of the medical profession. I consider the implications of this shift.
