Report / Royal Commission on the Law Relating to Mental Illness and Mental Deficiency 1954-1957.

  • Great Britain. Royal Commission on the Law Relating to Mental Illness and Mental Deficiency 1954-1957.
Date:
1957
Catalogue details

Licence: Public Domain Mark

Credit: Report / Royal Commission on the Law Relating to Mental Illness and Mental Deficiency 1954-1957. Source: Wellcome Collection.

    58/346 (page 46)
    important to bear in mind that when these Acts were passed, it was only patients covered by the terminology used in the Acts who were to be eligible for care in the hospitals or imstitutions provided under these Acts. Certification was originally necessary to establish the patient’s eligibility for these special forms of care at public expense, as well as to authorise his detention while under care. This is no longer the case. Alli public mental and mental deficiency hospitals are now provided under the National Health Service Acts, which authorise the general provision of “ hospital and specialist services” without mentioning, still less attempting to define, the types of mental or physical disorder for which treatment may be provided. Community care for defectives is still provided by local health authorities partly under the authority of the Mental Deficiency Acts, but general authority which would cover almost all these community services is contained in the National Health Service Acts or the National Assistance Act, 1948, without a definition of mental defectiveness being necessary. The limitations still placed on the types of patients who may be admitted to designated mental and mental deficiency hospitals now arise only from the fact that admission is regulated by the procedures laid down in the Lunacy and Mental Treatment Acts and Mental Deficiency Acts, which apply only to patients covered by the terminology used in these Acts. It should be possible in future to provide care without such special procedures for all patients who do not need to be subject to detention in hospital or legal control under guardianship in the community. It is only in connection with the procedures which authorise such detention or control that terms or definitions describing particular groups of patients are now needed in the law. Meaning of the terms “lunatic”, “idiot”, “insane” and “of unsound mind ”, and the terms proposed by the Royal Commission of 1904-08 152. The eighteenth and nineteenth century lunacy legislation did not give any precise definition of the sort of mental condition which was to be regarded as lunacy, idiocy, insanity or unsoundness of mind. It was assumed that these expressions would be understood by the doctors, justices and officials who administered the Acts. And in practice, although their meaning has varied in different contexts and at different periods, their interpretation for the purpose of the Lunacy Acts and Idiots Act did not give rise to serious disagreement either within the medical profession or between doctors, justices and non-medical officials. Great controversy has arisen over the meaning to be attached to the word “insane” in connection with the verdict “ guilty but insane” in criminal proceedings. This controversy has not centred round the general meaning of the word “insane”, but around the meaning to be attached to it in that particular context and the criteria for its inter- pretation which were laid down in the M’Naghten Rules in 1843. This question of the criminal responsibility of the insane is outside our terms of reference. We mention it only in order to point out that the term “insane ™ in the verdict “guilty but insane” and in the phrase “insane on arraign- ment” is applied in a narrower sense than that now given in practice by general consent to the phrase “person of unsound mind” as used in the Lunacy and Mental Treatment Acts. Many persons who are certifiable as ‘‘of unsound mind” under the Lunacy and Mental Treatment Acts are not insane within the meaning of the M’Naghten Rules. Nor would a mentally ill person, who is “of unsound mind” within the meaning of the Lunacy and Mental Treatment Acts when he is brought to trial, necessarily be found “insane on arraignment”.