Mental health services will collapse if draft legislation proposed by the government becomes law, the British Medical Association has warned.

Doctors' leaders are urging the government to re-think several key elements of the draft Mental Health Bill.

The Bill is so broadly drafted that it threatens the civil liberties of the whole population

Dr Robin Arnold

They say that although it contains many positive ideas, some aspects are flawed.

The most fundamental flaw, says the BMA, lies in the broad definition of mental disorder combined with the reduction in the severity threshold for compulsory detention.

Ministers have said the changes will provide safeguards for patients and protection for the public.

The Bill includes new powers to allow doctors to force people with severe mental illness to receive treatment without their consent.

But the BMA has listed a raft of concerns:

• The broad definition of mental disorder means that individuals with an untreatable learning disability or personality disorder or very mild conditions are included within the scope of the Bill.
• The changes to the definition of 'mental disorder' means that there are no clear boundaries as to who can be detained under what circumstances. This represents a fundamental threat to civil liberties.
• By including individuals with an untreatable personality disorder within the scope of a single procedure, legislation that is intended to help those who are ill may be used as a vehicle for social control.
• The changes will divert already severely limited resources away from those people who could benefit from mental health services.
• The proposed changes will increase workloads for a severely under-resourced service. According to the Royal College of Psychiatrists, just to administer the draft Mental Health Bill will require 600 more psychiatrists.

Dr Robin Arnold, chairman of the BMA's psychiatry committee, said: "As it stands the draft Mental Health Bill is fundamentally flawed.

"The Bill is so broadly drafted that it threatens the civil liberties of the whole population and the professional boundaries of psychiatrists."

GMC fears

The Medical Defence Union, which provides professional insurance for doctors, is concerned that the proposals may put doctors at odds with the General Medical Council.

If such a policy were implemented it could place clinicians in a difficult medico-legal position

Dr Tom Leigh

Under the current Act, people with mental impairment or a psychopathic disorder need to fulfill a requirement that "treatment is likely to alleviate or prevent a deterioration of this condition". This is known as the "treatability" test.

The consultation document proposes that this will be abolished.

Dr Tom Leigh, a MDU senior medical claims handler, said: "If such a policy were implemented it could place clinicians in a difficult medico-legal position.

"In some circumstances they would have a legal duty to act in one way, but their ethical duty would require them to act in another way.

"The MDU's interpretation of the relevant GMC guidance is that doctors have a positive obligation to provide treatment that is in the patient's best interest, based on a doctor's judgement of the patient's needs and the likely effectiveness of the treatment.

"If they don't think treatment will be effective, then they do not have to give it.

"However, if the bill proceeds as proposed, they may be required by law to give certain kinds of healthcare - even if they know it will not do any good - as the legislation may require them to."