Report of a research review aiming to undertake a systematic search and evaluation of all data pertaining to the Mental Health Act 1983 as a whole, and its different parts, identifying specific aspects of the Act which appear to work effectively and highlighting aspects which appear problematic or ineffective. Includes sections on: Part II and Part III of the Act.
Report of a research review aiming to undertake a systematic search and evaluation of all data pertaining to the Mental Health Act 1983 as a whole, and its different parts, identifying specific aspects of the Act which appear to work effectively and highlighting aspects which appear problematic or ineffective. Includes sections on: Part II and Part III of the Act.
Extended abstract:
Author
WALL Sharon; et al.;
Title
A systematic review of research relating to the Mental Health Act 1983.
Publication details
Great Britain. Department of Health, 1999.
Summary
The aim of this review was to undertake a systematic search and evaluation of all data pertaining to The Mental Health Act. The review was intended to provide an objective summary of the data pertaining to the Act as a whole and it's different parts, identifying specific aspects of the Act which appear to work effectively and highlighting aspects which appeared problematic or ineffective.
Context
The Mental Health Act (1983) (MHA) is an important legislative process intended to ensure a consistent and comprehensive approach to psychiatric care in England and Wales. In the 15 years since the MHA was introduced, mental health service provision has radically changed involving widespread hospital closures and the introduction of care in the community. There have been calls for changes in the legislation to reflect these changes in service provision. The use of, and procedures associated with the act have been much debated although there ahs been no systematic or objective review of the act since its introduction. The Department of Health commissioned King's College of Medicine and Dentistry to synthesise the data pertaining to the act.
Method
Part one and part two of the report have separate methodologies. The methodology utilised in part one included the obtaining of denominator data of psychiatric hospital admissions from the Department of Health Mental Health Division in order to determine the proportion of detained patients admitted to hospital. Data are presented as the total number of sections applied in each year for each section, and the proportion of admissions for which patients were sectioned. The methodology utilised for the systematic review involved conducting a thorough and comprehensive search involving Department of Health databases, routinely collected hospital and Trust data and general audit where available. Electronic databases such as Medline, PsycLit and Embase were also used to identify published articles and books and specialist journals were hand searched. Strict inclusion criteria and search strategies were utilised.
Contents
This review begins with an Executive Summary of each part of the report and then is divided into two parts. Part One of the report analyses the secular trends in the use of the Mental Health Act (1983) in England from 1984 to 1996. This section of the report is an attempt to describe and explore broad changes in the use of the act, the changes are explored in more detail by breaking down the use of the act into sections. Part one of the report is accompanied by seven figures which help to illustrate the findings. Part Two of the report is The Systematic Review and this section consists of five chapters. The fist chapter introduces the Systematic review and describes its aims and methodology. Chapter Two explores the use of the MHA as a whole and looks at how often the MHA is used and examines the characteristics of patients detained under the MHA. Chapter three examines Part II of the Mental Health Act (1983) which allows a person to be compulsory admitted or detained where this is necessary in the interests of his/her own health or safety and/or for the protection of other people. Chapter four examines Part III of the MHA (1983) which caters for mentally disordered people in the criminal justice system of England and Wales. Chapter five assesses the use of Part X of the MHA which gives police the power to remove a person to a place of safety pending an assessment by a doctor and approved social worker. Chapter six describes some papers that are not easily placed elsewhere in the review such as the use of electro-convulsive therapy under the MHA, aftercare and the training of staff in the use of the act, amongst others.
Conclusion
"Many different forces may act to change the way in which the MHA is used. It is therefore difficult to know what is responsible for the rise in the use of the MHA between 1984 and 1996. it is possible that the steady increase in the use of the MHA is an indicator of some of the opposing pressures impacting on modern psychiatry; the drive towards less hospital, more community based services versus public concerns about the 'threat' posed by the mentally ill. The practice of psychiatry is increasingly influenced by a reluctance to accept risk-taking and uncertainty and a recognition of the need for risk management (Holloway, 1996). The overall result may be a steady increase in the use of coercion, but increasingly fewer resourcesfor this purpose."
Part I 18 references Part 2 149 references
Subject terms:
law, literature reviews, mental health law, mental health problems, severe mental health problems;
Report of the expert committee commissioned to advise on how mental health legislation should be shaped to reflect contemporary patterns of care within a framework which balances the need to protect the rights of individual patients and the need to ensure public safety. The committee has primarily been concerned with providing a framework for compulsion in respect of certain people with severe mental health problems.
Report of the expert committee commissioned to advise on how mental health legislation should be shaped to reflect contemporary patterns of care within a framework which balances the need to protect the rights of individual patients and the need to ensure public safety. The committee has primarily been concerned with providing a framework for compulsion in respect of certain people with severe mental health problems.
Subject terms:
law, mental health law, mental health problems, severe mental health problems, compulsory detention;
Directions, under Section 17 of the National Health Service Act 1977, governing visits by children to special hospitals were made on 23 July 1999 to the Ashworth, Broadmoor and Rampton Hospital Authorities as Health Service Circular HSC 1999/160. A copy accompanies this circular.
Directions, under Section 17 of the National Health Service Act 1977, governing visits by children to special hospitals were made on 23 July 1999 to the Ashworth, Broadmoor and Rampton Hospital Authorities as Health Service Circular HSC 1999/160. A copy accompanies this circular.
Subject terms:
local government, mental health problems, mentally disordered offenders, secure hospitals, social services, children;
Describe the Children's Project, a project based in Stockholm to investigate the situation of the children of psychiatric patients and to develop a methodology for carrying out such studies.
Describe the Children's Project, a project based in Stockholm to investigate the situation of the children of psychiatric patients and to develop a methodology for carrying out such studies.
Subject terms:
mental health problems, mental health services, parents, personality development, child development, children, parental mental health;
The Government believes there is a clear need for reform of the law in order to improve and clarify the decision-making process for those who are unable to make decisions for themselves, or those who cannot communicate their decisions. These are some of the most vulnerable people in our society. The law in this area has developed in piecemeal fashion, and does not always offer sufficient protection either for mentally incapacitated adults, or for those who look after them.This Consultation Paper seeks views on a possible framework for providing that protection, and for providing an organised framework of law to manage the welfare and affairs of mentally incapacitated adults.
The Government believes there is a clear need for reform of the law in order to improve and clarify the decision-making process for those who are unable to make decisions for themselves, or those who cannot communicate their decisions. These are some of the most vulnerable people in our society. The law in this area has developed in piecemeal fashion, and does not always offer sufficient protection either for mentally incapacitated adults, or for those who look after them.This Consultation Paper seeks views on a possible framework for providing that protection, and for providing an organised framework of law to manage the welfare and affairs of mentally incapacitated adults.
Subject terms:
law, mental health problems, self-determination, severe mental health problems, vulnerable adults, decision making, guardianship, government policy;
British Medical Journal, 16.10.99, 1999, pp.1017-1018.
Publisher:
British Medical Association
The National Service Framework for Mental Health is part of the programme to establish better quality and reduce unacceptable variations in the NHS. The author of this article asserts that implementation is key to determining whether the framework is a support or a gallows.
The National Service Framework for Mental Health is part of the programme to establish better quality and reduce unacceptable variations in the NHS. The author of this article asserts that implementation is key to determining whether the framework is a support or a gallows.
Subject terms:
law, mental health problems, mental health services, NHS, quality assurance, social policy, standards, central government, community mental health services, evidence-based practice;
British Medical Journal, 2.10.99, 1999, pp.905-907.
Publisher:
British Medical Association
A British Medical Journal article on managing patients who harm themselves and refuse treatment prompted many requests for legal advice. This paper clarifies the legal issues.
A British Medical Journal article on managing patients who harm themselves and refuse treatment prompted many requests for legal advice. This paper clarifies the legal issues.
Subject terms:
law, mental health problems, hospital admission, self-harm, severe mental health problems, treatment, therapy and treatment, attempted suicide, ethics;
Reports on research which aims to gain information about children's mental health at the time they enter local authority care, with a view to planning an early intervention programme.
Reports on research which aims to gain information about children's mental health at the time they enter local authority care, with a view to planning an early intervention programme.
Subject terms:
intervention, mental health, looked after children, mental health problems, unmet need, children, depression, early intervention;