Writing in 1980 about the way the 1959 Mental Health Act operated, I thought that the procedures for deciding and detaining a patient for compulsory admission had not worked well (Bean 1980). GPs and social workers rarely knew their duties, rarely knew the law and rarely offered much by way of assistance to the psychiatrists — frankly, the GPs did what they were told. When the social workers disagreed with the psychiatrists, they were invariably outmanoeuvred into having to accept the psychiatrist’s opinion (ibid. 1980). There have been changes since then; the 1959 Act has been replaced by the 1983 Act, social workers are now required to be Approved, that is, they have to complete a recognised training programme, and GPs are said to be rather better trained than hitherto in their knowledge of mental health legislation. But have these changes greatly affected things? Has the 1983 Act improved the social worker and GP input, and has the training improved procedures? The answer is, probably yes, at least in some respects, but we do not know for certain; unfortunately what has not changed has been the amount of research, which still remains unacceptably small.
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