Mental health legislation in most jurisdictions (including England and Wales) discriminates against people with a mental illness.
When it comes to involuntary treatment, it fails to respect -- without adequate justification -- the "autonomy" of people with a mental illness, in stark contrast to the treatment of people with a physical illness. It further discriminates against persons with a mental disorder by allowing a form of preventive detention on the basis of 'risk', without any offence having been committed. Mental health legislation thus carries underlying assumptions that people with mental disorders are not fully self-determining and that they are inherently dangerous. It is possible to frame a law based on impaired decision-making capacity, from whatever cause (whether due to a mental or physical disorder), that would counter such discrimination.
Professor of Psychiatry and Society Co-Director, King's Health and Society Centre, King's College London
Dr Szmukler is a psychiatrist who has had major research interests in eating disorders and family carers of people suffering from a psychotic illness. His major research now concerns methods of reducing compulsion and "coercion" in psychiatric care, for example, through the use of "advance statements." A related interest is mental health law, particularly the possibility of generic legislation centred on impaired decision-making capacity which would apply to all persons, regardless of the cause of the underlying disturbance of mental functioning.
Dr Szmukler is Co-Director (with Professor Brian Salter) of the King's Health and Society Centre. This provides a framework for interdisciplinary research linking health and healthcare with the social sciences, law and the humanities. He is also an Associate Director of the NIHR Mental Health Research Network, with lead responsibility for Patient and Public Involvement (PPI). A major aim is to increase the involvement in mental health research of service users and carers as research partners, as well as to engage the interest and support of the general public. Dr Szmukler is a Visiting Professor in the Department of Sociology (in BIOS) at the London School of Economics.
Past posts have included Dean of the Institute of Psychiatry (2001-2006), and Medical Director of the Bethlem and Maudsley NHS Trust (1997-1999) then joint Medical Director of the South London and Maudsley NHS Trust (1999-2001).