“Those that the gods would destroy they first make mad” is a quotation misattributed to Eupirides and is a historical example of the negative connotations and stigma experienced by individuals with mental health problems. These have been perpetuated through the centuries and continue to be enshrined in current UK legislation, which restricts the ability of individuals with mental health problems to undertake certain activities. This includes ineligibility for jury service if the individual is receiving treatment for their mental health (e.g. antidepressant medication or psychological counselling), and removal of a company director or a member of parliament from their position if they are detained for more than six months under the Mental Health Act. This is clearly discriminatory as there are no equivalent provisions for those suffering from incapacitating physical health conditions. The Mental Health (Discrimination) Bill aims to repeal these outdated pieces of legislation and help reduce the stigma and discrimination that is pervasive in the lives of many individuals with mental health problems.
This bill was backed by organisations including the Royal College of Psychiatrists, MIND, and Rethink Mental Illness. The bill introduced by Conservative MP Gavin Barwell had crossparty support. His reasoning for choosing this subject included the fact that 25% of people in the UK will suffer a mental health condition in their lifetime and the World Health Organization estimates that depression will be the commonest health condition by 2030. The bill passed its second reading unanimously in the House of Commons on Friday 14 September 2012. There were several deeply personal and eloquent speeches by a number of the MPs present for the reading. Dame Anne Begg MP, who has a physical disability, spoke about the differences in the legislature treatment of mental and physical health problems. Charles Walker MP, who had previously described his problems with obsessive compulsive disorder and Kevan Jones MP, with a history of depression both voiced their support.
There was consensus in Parliament that UK legislation should treat mental health problems on the same basis as physical health disease and that the mental capacity of an individual was the most important factor determining their ability to take part in the various activities described above. Given the ageing population in this country, the result of which is that comorbidity is the rule as opposed to exception, it is clearly important to move towards a holistic and integrative approach in dealing with health problems. This bill is a step in the right direction to reduce the arbitrary divisions between physical and mental health resulting in unacceptable stigma and discrimination.
Jega Aravinthan is a ST6 specialty registrar in general adult psychiatry in the East of England Deanery and currently working at the West Essex Community Drug and Alcohol Team. He was previously a principal in general practice. He has have qualifications in law and is interested in its relation to medicine. He would like to thank professor Simon Dein and Dr Bhagat Sharma for their advice and guidance.
The author has completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author). The author declares the following remunerated positions in the past 3 years: he was formerly a full time GP Principal and Joint Mental Health Lead in Bexley; and he continues to serve on the board of Bexley Community and Mental Health Services Limited, which in conjunction with Mind in Bexley, provides primary care counselling and IAPT psychological services to the population of Bexley. The author declares he has received no support from any organisation for the submitted work and no other relationships or activities that could appear to have influenced the submitted work.