Journal of Mental Health, 14(5), October 2005, pp.435-443.
Publisher:
Taylor and Francis
Place of publication:
London
Recently the British government has issued a Draft Mental Health Bill, which offers a definition of mental disorder. The authors analyse this definition in logical and empirical terms. It is also contrasted with previous struggles in the professional literature to provide a cogent and credible definition of mental disorder. Socio-historical forces are described relevant to this current lack of clarity and credibility. They argue that all efforts to date to define mental disorder have been flawed on a number of counts. The concept of mental disorder is of dubious scientific validity but it has a substantial political utility for several social groups who are sane by mutual agreement.
Recently the British government has issued a Draft Mental Health Bill, which offers a definition of mental disorder. The authors analyse this definition in logical and empirical terms. It is also contrasted with previous struggles in the professional literature to provide a cogent and credible definition of mental disorder. Socio-historical forces are described relevant to this current lack of clarity and credibility. They argue that all efforts to date to define mental disorder have been flawed on a number of counts. The concept of mental disorder is of dubious scientific validity but it has a substantial political utility for several social groups who are sane by mutual agreement.
Subject terms:
mental health law, mental health problems, government policy;
Health and social care professionals may face civil and criminal proceedings if the quality of their care and treatment is challenged. Therefore it is important that mental health service users, their representatives and carers are aware of the forms of offences identified under Part IX of the 1983 Mental Health Act. This article briefly looks at some of the key offences and considers what concerned individuals may do. It covers forgery and false statements; ill treatment of patients; assisting patients to absent themselves without leave; and obstruction.
Health and social care professionals may face civil and criminal proceedings if the quality of their care and treatment is challenged. Therefore it is important that mental health service users, their representatives and carers are aware of the forms of offences identified under Part IX of the 1983 Mental Health Act. This article briefly looks at some of the key offences and considers what concerned individuals may do. It covers forgery and false statements; ill treatment of patients; assisting patients to absent themselves without leave; and obstruction.
Subject terms:
legal proceedings, mental health law, mental health problems, sexual offences, duty of care;
Psychiatric Bulletin, 29(7), July 2005, pp.244-247.
Publisher:
Royal College of Psychiatrists
Apart from the support for advocacy, it seems reasonable to conclude that this Bill is lacking in the remaining principles enunciated in the key policy documents that have provided a framework for our discussion. The authors doubt that legislation not founded on the national and international principles underlying modern mental health services can further the objectives of those services. Instead we have concerns that such ungrounded law will undermine the aspirations of both users and providers of mental health services to act in accordance with fundamental principles such as dignity, autonomy, empowerment, access and non-discrimination. In this sense it may not only be without principles, but there is a danger that in some circumstances (for example, when there are pressures for increased social control) its use could become unprincipled.
Apart from the support for advocacy, it seems reasonable to conclude that this Bill is lacking in the remaining principles enunciated in the key policy documents that have provided a framework for our discussion. The authors doubt that legislation not founded on the national and international principles underlying modern mental health services can further the objectives of those services. Instead we have concerns that such ungrounded law will undermine the aspirations of both users and providers of mental health services to act in accordance with fundamental principles such as dignity, autonomy, empowerment, access and non-discrimination. In this sense it may not only be without principles, but there is a danger that in some circumstances (for example, when there are pressures for increased social control) its use could become unprincipled.
Subject terms:
mental health law, mental health problems, service users, empowerment, ethics;
British Medical Journal, 17.12.05, 2005, pp.1467-1469.
Publisher:
British Medical Association
The authors argue new legislation should raise the moral standards of professional and personal life, but that the proposed new mental health bill fails to deal with the serious ethical problems in the existing 1983 Mental Health Act.
The authors argue new legislation should raise the moral standards of professional and personal life, but that the proposed new mental health bill fails to deal with the serious ethical problems in the existing 1983 Mental Health Act.
Subject terms:
independence, mental health law, mental health problems, attitudes, compulsory detention, decision making;
Psychiatric Bulletin, 29(7), July 2005, pp.250-251.
Publisher:
Royal College of Psychiatrists
Better compliance with treatment is the most common factor identified by doctors as likely to have prevented homicides and suicides by patients. That is no reason for a massive increase in the number of patients compelled to take their treatment, but it is a powerful argument for making sure that the law minimises obstacles to optimum clinical care. Politicians will take the lead, as they have done over the Dangerous People with Severe Personality Disorder (DSPD) initiative. Psychiatry is fast losing a political and public relations battle and patients will suffer when they are further marginalised. Mentally ill people can commit the most serious offences yet not spend a day in prison, with courts giving priority to their treatment and rehabilitation over any thoughts of punishment or retribution.
Better compliance with treatment is the most common factor identified by doctors as likely to have prevented homicides and suicides by patients. That is no reason for a massive increase in the number of patients compelled to take their treatment, but it is a powerful argument for making sure that the law minimises obstacles to optimum clinical care. Politicians will take the lead, as they have done over the Dangerous People with Severe Personality Disorder (DSPD) initiative. Psychiatry is fast losing a political and public relations battle and patients will suffer when they are further marginalised. Mentally ill people can commit the most serious offences yet not spend a day in prison, with courts giving priority to their treatment and rehabilitation over any thoughts of punishment or retribution.
Subject terms:
mental health law, mental health problems, treatment compliance, compulsory detention, compulsory treatment, ethics, forensic psychiatry;
Psychiatric Bulletin, 29(7), July 2005, pp.248-249.
Publisher:
Royal College of Psychiatrists
Despite the drafters’ best intentions, the proposed Mental Health Act is unlikely to advance the agenda of community safety. The response however, not be a rejection of the understandable, and politically unavoidable, drive for better management of the risks of violence to others. The response should be to use the evidence base concerning the association between mental disorders and violence to inform both public policy and mental health practice. A greater willingness to accept and respond to the general public’s fears of violent behaviour in the mentally ill may produce a political climate more receptive to our advocacy for better services and a greater sensitivity to the rights of our patients. It is particularly important that it is made clear that the best way of reducing criminal behaviour among the seriously mentally ill is neither institutionalisation nor compulsory community treatment orders, but improved services that focus on symptom control, support, appropriate accommodation, behavioural and cognitive therapies and active social and economic rehabilitation.
Despite the drafters’ best intentions, the proposed Mental Health Act is unlikely to advance the agenda of community safety. The response however, not be a rejection of the understandable, and politically unavoidable, drive for better management of the risks of violence to others. The response should be to use the evidence base concerning the association between mental disorders and violence to inform both public policy and mental health practice. A greater willingness to accept and respond to the general public’s fears of violent behaviour in the mentally ill may produce a political climate more receptive to our advocacy for better services and a greater sensitivity to the rights of our patients. It is particularly important that it is made clear that the best way of reducing criminal behaviour among the seriously mentally ill is neither institutionalisation nor compulsory community treatment orders, but improved services that focus on symptom control, support, appropriate accommodation, behavioural and cognitive therapies and active social and economic rehabilitation.
Subject terms:
mental health law, mental health problems, mentally disordered offenders, rehabilitation, violence, ethics;
The Mental Capacity Act 2005 should ensure that all people are able to make their own choices unless proven otherwise. Looks at the need for professionals to adjust quickly to the new provisions. Also looks at the role of the new independent mental capacity advocates.
The Mental Capacity Act 2005 should ensure that all people are able to make their own choices unless proven otherwise. Looks at the need for professionals to adjust quickly to the new provisions. Also looks at the role of the new independent mental capacity advocates.
Subject terms:
learning disabilities, mental health law, mental health problems, vulnerable adults, advocacy, decision making, dementia;
The Deprivation of Liberty Safeguards were inserted into the Mental Capacity Act 2005 by the Mental Health Act 2007. They protect against the arbitrary detention of people who lack the capacity to consent to the arrangements made for their care or treatment and who need to be deprived of their liberty, in their own best interests and for their own safety, in either hospitals or care homes. They will rectify the breach of Article 5 of the European Convention on Human Rights identified by the European Court of Human Rights in HL v UK 2004 (the 'Bournewood' case).Section 42 of the Mental Capacity Act 2005, requires the Lord Chancellor to issue a Code of Practice to provide information and guidance on how the safeguards will work in practice. A draft version of the Code was published for full public consultation in 2007. 110 individuals and organisations responded and many of the suggestions and comments received have been incorporated into the final version. The Act requires a range of people to 'have regard' to the Code, for example anyone acting in a professional or paid role in relation to someone who lacks capacity, but it particularly focuses on those who have a duty of care to a person who lacks the capacity to consent to the care or treatment that is being provided, where that care or treatment may include the need to deprive the person of their liberty. The Code is intended to provide valuable information and guidance to all those covered by the Act and has been written to meet the needs of this wide and varied audience.
The Deprivation of Liberty Safeguards were inserted into the Mental Capacity Act 2005 by the Mental Health Act 2007. They protect against the arbitrary detention of people who lack the capacity to consent to the arrangements made for their care or treatment and who need to be deprived of their liberty, in their own best interests and for their own safety, in either hospitals or care homes. They will rectify the breach of Article 5 of the European Convention on Human Rights identified by the European Court of Human Rights in HL v UK 2004 (the 'Bournewood' case).Section 42 of the Mental Capacity Act 2005, requires the Lord Chancellor to issue a Code of Practice to provide information and guidance on how the safeguards will work in practice. A draft version of the Code was published for full public consultation in 2007. 110 individuals and organisations responded and many of the suggestions and comments received have been incorporated into the final version. The Act requires a range of people to 'have regard' to the Code, for example anyone acting in a professional or paid role in relation to someone who lacks capacity, but it particularly focuses on those who have a duty of care to a person who lacks the capacity to consent to the care or treatment that is being provided, where that care or treatment may include the need to deprive the person of their liberty. The Code is intended to provide valuable information and guidance to all those covered by the Act and has been written to meet the needs of this wide and varied audience.
Subject terms:
mental health law, mental health problems, patients, psychiatry, self-determination, compulsory detention, Deprivation of Liberty Safeguards, ethics;
This book is for practitioners who work in drug and alcohol services or other settings such as health, social care and criminal justice. It gives an overview of the link between drug misuse and mental health. The booklet covers the following topics: mental health problems; commonly prescribed medication for mental health; mental health services - what do they do?; drug use and mental health - dual diagnosis; roles of the drug worker - responding to drugs and mental health issues; and summaries of mental health law, standards and guidance.
This book is for practitioners who work in drug and alcohol services or other settings such as health, social care and criminal justice. It gives an overview of the link between drug misuse and mental health. The booklet covers the following topics: mental health problems; commonly prescribed medication for mental health; mental health services - what do they do?; drug use and mental health - dual diagnosis; roles of the drug worker - responding to drugs and mental health issues; and summaries of mental health law, standards and guidance.
Extended abstract:
Author
VOSE Colin
Title
Mental health and drugs: a drug workers' guide to working with service users who have a mental illness
Publisher
HIT, 2005
Summary
This booklet is for practitioners who work in drug and alcohol services or other settings such as health, social care and criminal justice. It gives an overview of the link between drug misuse and mental health.
Context
There is increasing concern about the link between drug use and mental health problems. People with drug problems are more likely than the rest of the population to have mental health problems, and people with mental health problems are more likely to have drug problems. Mental health and drug services have gaps in service provision and knowledge with the result that many individuals with both problems find themselves being passed between services, each service claiming it is ill-equipped to respond to the combination of drug dependence and mental illness.
Contents
The booklet seeks to provide drug workers with a sufficient knowledge base about mental health problems to ensure they can recognise and assess mental health problems in the client group and liaise with and work alongside mental health services to deliver effective care. The introduction outlines the extent and nature of illicit drug use in the UK ; use by young people and the general population; effects, risks and harms; and the pattern of drug use. Section 1 explains mental health problems, with sections on neurosis, depression, anxiety states, insomnia, eating disorders, post-traumatic stress disorder, personality disorder, psychosis, organic psychosis, functional psychosis, hallucinations, delusions, schizophrenia, psychosis and mania, schizoid-affective disorder, bipolar disorders, suicide, diagnosing mental health problems, early diagnosis of psychosis, and the cost of mental illness. Section 2 describes commonly-prescribed medication for mental illness: anti-psychotics, anti-depressants, and minor tranquillisers and sleeping tablets, and interactions between prescribed and abused medication. It also states there is more to treating mental illness than medication, and discusses the drug worker's paradox: his or her aim is to reduce harmful drug use; the mental health worker's role is often to encourage them to take their prescribed drugs. Section 3 explains what mental health services do, outlining primary and secondary care, the community mental health team, assertive outreach, crisis resolution and the home treatment team, the early intervention team, the acute psychiatric hospital ward, the psychiatric intensive care unit, and the way in and out of mental health services. Section 4 discusses the dual diagnosis of drug use and mental health (co-morbidity), with sub-sections on the prevalence of substance misuse among those with severe and enduring mental health problems and of mental health problems among substance-misuse populations, and the relationship between drug misuse and mental health. It summarises the links between certain drugs and mental health problems, discussing cannabis, dopamine, other psychedelic drugs, stimulants, and alcohol. Section 5 is about the role of the drug worker in responding to drugs and mental health issues: assessment, treatment and care at three levels (screening and referral, drug use triage assessment, and comprehensive drug use assessment); key indicators of mental health and/or substance misuse problems; risk assessment; care planning and the care programme approach; and discharge planning. Section 6 summarises mental health law. Section 7 describes standards and guidance: the National Service Framework for Mental Health, the Department of Health Dual Diagnosis Good Practice Guide, the UK drugs strategy, and the National Treatment Agency and Models of Care. It ends with a “Must do!” list and three case studies, giving for each the required action and a summary. Sources of further information are listed.
13 references
Subject terms:
medication, mental health care, mental health law, mental health problems, mental health services, standards, drug misuse, dual diagnosis;