This question is posed in the title of a symposium to which I have been invited to contribute (organised by Cygnet Health Care London, 30 November 2006). It is also highly relevant to a staff seminar I have been invited to give at Grendon Prison on 17 November.
A succinct summary of the contentious history behind the question is provided by the Royal College of Psychiatrists website:
The Government announced its intention to reform the Mental Health Act (1983) in September 1998. Since then, there has been a Green Paper, a White Paper and a Draft Bill; the Government published a revised Draft Bill in September 2004. Parliament then established a twenty-four-member Scrutiny Committee of Peers and MPs to report on the proposals. In March 2006 the Government abandoned its plans to pursue a new Act and instead decided to amend the 1983 Act. A Bill to amend the old Act is expected this year.
The political impetus behind the Governments proclaimed intention to produce a new act or amend the old one is provided by the sensational media coverage of a few extremely rare events. The single event widely held responsible for the Governments proclaimed determination in 1998 to reform the 1983 Act was the murder committed by Michael Stone in 1996 of Lin and Megan Russell. Stone, with the benefit of psychiatric hindsight, was apparently a known time-bomb waiting to explode. Why had he been left at liberty to commit his horrific crimes?
And why, ten years after the murders and eight years after the Governments declaration of its intention to change the law so that such things could never happen again, has nothing happened?
The answer can be found in paragraph 10 of the Governments response to the report of the Scrutiny Committee (PDF). The Government protests that the report misunderstands its intentions:
First of all, the report says that the legislation should be about improving services. The Bill is not about service provision. It is about the legal processes for bringing people under compulsion.
Amongst the improved services that the Scrutiny Committee considered central to a reformed Mental Health Act was protection of the civil liberties of those with mental problems. For the past eight years it has proved impossible to gain agreement about the balance to be struck between the threat to the public of dangerous psychopaths roaming free, and the threat to those with mental disorders of a law that would permit the detention of innocent people on suspicion that they might commit a crime.
This is a debate that I ventured into in a 2002 essay Risk and the impact of psychiatric disorder on the environment [PDF]. Has there been any progress in the four years since?