Listen to the Lords

There can be few more emotive questions than the appropriate protective powers of the state over mentally ill people. Cases like that of Michael Stone - who, 11 years ago, bludgeoned to death Lin Russell and her daughter Megan - arouse deep-seated and understandable fears about dangerous men being allowed out on the loose. But set against such cases are stories like that of Randle McMurphy, who in One Flew Over the Cuckoo's Nest was destroyed at the hands of a mental institution. It is a fictional tale, but one which too often finds echoes in real-life reporting, which time and again has exposed how ruinous the behaviour of the over-stretched authorities can become once they are freed of the need to be led by the wishes of the patient.

So, there will be no shortage of horror stories on either side of the argument when MPs today consider giving a second reading to the mental health bill. But these must not be allowed to overwhelm the calm judgment needed to ensure that public safety and individual rights are properly balanced. The impulse for reform began fully nine years ago, when, in the light of Michael Stone's conviction, the government signalled that it wished to bolster the power of medics pre-emptively to detain and attempt to treat those who, like Stone, suffered from severe personality disorders - or, in more traditional terms, were psychopaths - even where no treatment of proven effectiveness is available.

Legislation designed to answer outrage over terrible but rare events does not have a happy history, and experts have long feared that the plans could be a distraction from bigger risks and impact adversely on mentally ill people more widely. After all, they point out, 20 times more murders are committed by sane than by insane people, and many more of those with mental illness are more a danger to themselves than to anyone else. Many more again experience mental illness without being a danger to either, yet even this wider group - one in six of all individuals - could be put off seeking help if mental health services are perceived as increasingly coercive. Tougher legislation might not even prevent a repeat of the tragedy that originally provoked it: the inquiry into the Russell murders finally reported last year - it identified failures of communication between those agencies who had handled Stone, but not any specific loopholes in the rules governing mandatory treatment.

Yet any system, including the current one, which allows for enforced detention and treatment in hospital of those who are a danger to themselves or others, has a difficult balance to strike, and, given the move from hospital to community-based treatment, it is legitimate to review this. Last year attempts at a wider overhaul were abandoned and the current bill focuses specifically on modifying the existing conditions under which compulsory treatment and compulsory detention can be imposed.

But it remains too cavalier. MPs should lend their support to the Lords, who in its scrutiny of the bill introduced a number of carefully considered amendments, which - although the government is now seeking to reverse them - would not wreck the bill, but strengthen it. The Lords did not reject orders for compulsory treatment in the community out of hand, but did seek to restrict it specifically to "revolving door patients" - people who have repeatedly failed to keep up with medication on release from hospital, and who pose a danger to others. It further, reasonably, proposed that treatment should not be imposed on those deemed to retain the full capacity to make up their own minds. And on detention, the Lords insists that treatability should remain an essential condition - that has to be right when it alone can offer the hope of rehabilitation and release, which those suffering custody without having committed any crime are surely entitled to.