by Pamela Readhead

Earlier this week (16 April) the revised Mental Health Bill, including safeguards added by the Lords, gained its second reading without a vote. But the government may still face a rough ride when the bill returns to parliament for a third reading in May. Health minister Rosie Winterton has vowed to overturn several of the House of Lords' amendments during the committee stage but several backbench Labour MPs have joined opponents of the bill in backing them.

The government has been trying to overhaul mental health laws since 1998 when it was spurred into action by the conviction of Michael Stone for the murders of Lin and Megan Russell. Every year around 55 to 60 murders are committed by people who are mental health patients and the provisions in the bill are aimed at reducing such tragedies. The reforms would affect an estimated 14,000 of the 600,000 people who use mental health services each year.

The bill, which will allow people to be held against their will even if they have not committed a crime, has been attacked by the Tories as "punitive" and has been opposed by Mental Health Alliance, which represents 80 professional bodies and support groups. It has been welcomed by the Zito Trust, an organisation for the victims of people with mental disorders.

Under the House of Lords' amendments compulsory community treatment would be restricted to patients who would otherwise be in and out of hospital and people would not be sectioned unless their ability to make decisions about their treatment was impaired.

ESRC researchers in Scotland, where the social and economic costs associated with mental health problems totalled £8.6 billion in 2004-5, have found that community gardening and art can help people with profound long-term mental health problems develop basic skills and build personal confidence and self-esteem. The three-year research project on mental health and social inclusion helped people to integrate with their neighbourhoods and also challenged the stigma that can surround mental health issues. A film about the project entitled Recovering Lives: Mental health, gardening and the arts has been made by Dr Hester Parr, Reader in Geography, University of Dundee.

"There is great value in activities such as gardening and the arts for people with severe and enduring mental health problems," said Dr Parr. "Not only in therapeutic terms, but in helping them integrate into their communities and challenge stigmatising attitudes to mental ill health. Some of the projects we have looked at operate gardens right in the heart of the community in which people work positively for wellbeing. Artistic projects also enable people with mental health problems to be valued for their contribution to their local cultural heritage."

Other areas of research aim to better understand mental health through cognitive psychology. Researchers at the University of Oxford are doing experimental work to develop new techniques to help treat mental health disorders. They have recently started investigating how biases in certain psychological processes work in healthy adults and people suffering from mild depression. They think that techniques developed in the laboratory could eventually be used to support cognitive behaviour therapy in clinical practice.

Dr Emily Holmes, who is leading the project, says "We need to understand the basic processes underlying emotional distress in order to develop better treatments in the future for a range of mental health problems. It is well known that depressed people often have an underlying negative bias in the way they filter information."

"For instance, if a friend fails to greet them in the street they may think they have been blanked, although the friend might just have been preoccupied. We are in the early stages of exploring computerised techniques to try to train people to replace habitual negative interpretations with more positive ones."

Dr Holmes' team is also exploring novel ways of working with mental imagery which could eventually be used to help people who suffer from distressing flashbacks, that may continue for decades after a traumatic event. She says that high quality scientific research is needed to better understand the basic processes underlying complex mental health difficulties, and more funding should be invested. Basic research may take time to translate into clinical reality, but is much needed in the field of mental health.