Press Releases
Public Consultation on the Proposed Mental Health (Care and Treatment) Bill
20 February 2008
This article has been migrated from an earlier version of the site and may display formatting inconsistencies.
20 Feb 2008
The Ministry of Health would like to invite public feedback on the Mental Health (Care and Treatment) Bill (“MHCT Bill”). The proposed Bill is necessary to ensure relevance as the existing Mental Disorders and Treatment Act (MDTA) will be repealed. The Bill enhances certain safeguards to protect the interests of patients who are compulsorily admitted into psychiatric institutions. MOH is also taking the opportunity to update the penalty provisions to reflect current economic realities and the seriousness of the offences, and to be on par with equivalent legislation.
Background
2 The Mental Disorders and Treatment Act (MDTA) regulates proceedings in cases of mental disorder, and provides for the reception and detention of persons of unsound mind in mental hospitals. The present MDTA comprises of 3 parts:
a) Part I - Provisions regulating proceedings in inquiries into mental disorders, including the appointment of Committees of Person and Estate to manage the affairs of persons suffering from mental disorder;
b) Part II - Provisions for the admission and detention of persons of unsound mind in mental hospitals;
c) Part III - General provisions.
3. The Ministry of Community, Youth and Sports (MCYS) had earlier conducted a public consultation on the Mental Capacity Bill (“MC Bill”) from Aug to Nov 2007. The MC Bill replaces Part I of MDTA and proposes an entirely new scheme based on the UK Mental Capacity Act.
4. Accordingly, Parts II and III of the MDTA would be replaced by the Mental Health (Care and Treatment) Bill (“MHCT Bill”). The main purpose of the legislation remains unchanged. That is, it allows for the detention of a person at a psychiatric institution for treatment if:
(a) he is suffering from a mental disorder which warrants the detention of the person in a psychiatric institution for treatment;
and
(b) it is necessary in the interests of the health or safety of the person or for the protection of other persons that the person should be so detained.
5. Similar to the MDTA, the MHCT Bill provides for multiple safeguards. These include:
a. Mentally disordered persons may only be detained in psychiatric institutions designated by the Minister for Health.
b. The psychiatric institution is to be inspected regularly by visitors appointed by the Minister for Health.
c. Only medical practitioners that have been designated by name or office in writing by the Director of Medical Services may sign an order for admission and detention.
d. A Magistrate’s order is required if the period of detention exceeds 6 months.
e. Penalties for improper reception or detention of mentally disordered persons.
Scope of Proposed Changes
6. The proposed main changes in MH(CT) Bill are largely technical in nature and pertain to definitions, procedures and penalties. These changes are as follows:
Definitions
A. Provision for the whole or any part of a hospital to be designated as a psychiatric institution
Under the MDTA, the whole hospital has to be designated by the Minister for Health as a mental hospital for the reception and detention of mentally disordered persons. Clause 3 of the MH(CT) Bill empowers the Minister for Health to designate a part of a hospital (e.g. a psychiatric department), instead of the whole hospital (e.g. IMH), for this purpose.
Currently, general hospitals such as Changi General Hospital and Tan Tock Seng Hospital have wards for the treatment of psychiatric patients. In addition to psychiatric treatment, mentally disordered persons who are warded in general hospitals would also receive medical and surgical treatment if required. Clause 3 of the MH(CT) Bill will allow these psychiatric wards to be designated as psychiatric institutions.
Terms such as “mental hospital”, which are out of date, will be replaced with “psychiatric institution”.
Procedures
B. Provision for detention of mentally disordered persons who had initially admitted themselves voluntarily
Under the MDTA, there is no provision for an existing inpatient of a psychiatric institution (ie. a patient who was admitted voluntarily) to be detained for further treatment if he is assessed to be a danger to himself or others. Clause 10(1)(b) allows a designated medical practitioner at the psychiatric institution to order an inpatient to be detained for further treatment, without requiring the patient to be first discharged from the psychiatric institution. This ensures that such patients may be treated without delay.
C. Increased flexibility in the frequency of inspections
Clause 5(a) provides that two or more visitors shall inspect the psychiatric institution at least once every three months. The present frequency is at least once every month. This is to allow for greater flexibility in the conduct of the visits where there has not been any adverse reports received, or in smaller psychiatric institutions (e.g. a ward in a hospital) which may not always have patients which were admitted pursuant to the Act.
D. Reduction in the period of further detention
After the first month of detention under the MDTA, an order for the further detention (hereafter referred to as an “order for further detention”) of the patient for a period not exceeding 12 months may be issued by two medical practitioners (one of whom must be a psychiatrist). Beyond this, an order of a Magistrate is required to detain the patient for further periods not exceeding 12 months. We propose to reduce the maximum period of detention under the order of further detention to 6 months. To detain a patient beyond this, an order of a Magistrate is required. This protects patient interests, by subjecting the necessity of continued detention to the early review of the Magistrate.
E. Increase in penalties for improper reception or detention of mentally disordered persons
The penalties for offences have been updated, to ensure their deterrent effects.
a) Cruel treatment / wilful neglect of patient (clause 22(1)) – penalty increased from maximum fine of $500 and / or imprisonment of 2 years, to maximum fine of $5,000 and / or imprisonment of 4 years.
b) Sexual intercourse with patient (clause 22(2)) – penalty increased from maximum fine of $1,000 and / or imprisonment of 2 years, to maximum fine of $5,000 and / or imprisonment of 10 years.
c) Improper reception or detention of patient (clause 26) – penalty increased from maximum fine of $2,000 and / or imprisonment of 2 years, to maximum fine of $5,000 and / or imprisonment of 3 years.
7. From now till 14 March 2008, MOH is seeking views and feedback from the public and stakeholders on this proposed bill. The draft bill is available on MOH website (www.moh.gov.sg). All feedback can be emailed to moh_info@moh.gov.sg or mailed to Ministry of Health (Customer Relations Branch), College of Medicine Building, 16 College Road, Singapore 169854.