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Black robes and white coats: who will win the new mental health tribunals?

Under current proposals for new mental health legislation, psychiatrists increasingly will be involved in tribunal processes examining the grounds for compulsory detention and treatment, both in hospitals and in the community. They will lose some authority over admission and discharge, with decision-making instead being given over to legal bodies that will regulate admission and discharge. The proposals for wholesale change in UK mental health law are an opportunity to devise a new type of legal hearing where all ‘sides' are properly represented. However, the new mental health tribunals proposed in the draft UK bill sit in a twilight zone of ‘quasi-criminal’ courts. The use of single joint experts or ‘expert panels', consistent with the recent civil law reforms, means that problems of undisputed medical evidence may become even more acute. American experience shows that judicial deference to clinical opinion, even in overtly adversarial commitment hearings, is considerable (Bursztajn et al, 1997). In this editorial, we argue that these proposals justify a re-examination of the values of law and psychiatry.