Child psychiatric care occurs within a complex legal framework that has seen major changes in recent years, particularly with the Mental Capacity Act 2005, the Mental Health Act 2007 and the Children Act 2004. So a book such as Anthony Harbour's is welcomed when it promises readers an ‘accessible and jargon-free guide’ to the law in this area.
So, what works well? The chapters on service provision and the case law on treatment refusal are engaging and well written, showcasing the author's knowledge of these areas. The service provision chapter highlights statutory responsibilities of health and local authorities in meeting the needs of children and carers, relevant to inter-agency negotiation and care planning. The ‘refusal cases’ highlight the previous underuse of the Mental Health Act in children, the issue of stigma, and an increasing awareness of its benefits and safeguards.
Unfortunately, the bulk of the book struggles to put the law into context or to summarise key principles. There are no introductory or concluding chapters, for example. Instead it offers the ‘letter of the law’, rather like a revision guide for law students, but without the bullet points, summaries and case commentaries that assist learning. Furthermore, the text itself is hard to follow. Often it makes reference to sections of statute which have not yet been introduced, assuming the reader already knows what they mean. The result is a sense of frustration, confirming the reader's anxiety about the complexity of the law.
However, the main problem is that the Mental Health Act 2007 came into effect as this book was being published, so it refers primarily to the 1983 Act, the 2007 amendments mentioned as interesting extras. The appendix includes a chapter from the Draft Code of Practice, which has since been revised.
Overall, this book does not achieve its aim of making the law in relation to young people accessible to the general reader. As a concise, authoritative and practical guide to the current legal framework, the recent National Institute for Mental Health in England publication 1 does much better. Together with the Codes of Practice for the Mental Health Act and Mental Capacity Act, this provides busy clinicians the working knowledge needed to practice confidently and lawfully.
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