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Good practice guidance: provision of hospital treatment for physical illness where a person with a mental disorder refuses treatment
- Author:
- MENTAL WELFARE COMMISSION FOR SCOTLAND
- Publisher:
- Mental Welfare Commission for Scotland
- Publication year:
- 2010
- Pagination:
- 7p.
- Place of publication:
- Edinburgh
The presence of mental disorder may, for some people, be a barrier to necessary physical health care if the person lacks capacity. This guidance refers specifically to the situation where the person refuses to attend hospital in a situation where others think that such attendance for physical health reasons is necessary. The guidance emphasises the need to carry out a proper assessment of capacity; the need to take account of the views of the individual and other with an interest; and the need to base interventions on an analysis of the risks and benefits, including the risk of not intervening. A flow chart shows the decisions that can be made mental health and incapacity law. Case study examples are also provided.
Intensive home treatment, admission rates and use of mental health legislation
- Authors:
- FORBES Naida F., CASH Helen T., LAWRIE Stephen M.
- Journal article citation:
- Psychiatrist (The), 34(12), December 2010, pp.522-524.
- Publisher:
- Royal College of Psychiatrists
An intensive home treatment team was launched when adult community mental health services were reconfigured in a redesign of the mental health service in Midlothian (a semi-rural area near Edinburgh) which included closure of a local adult in-patient ward. The aim of this study was to examine the effect of introducing a home treatment team on the rates of in-patient care and compulsory treatment in the local area. The results of the study showed that rates of admission to hospital and duration of hospital stay were unchanged, but that there was an increase in episodes of detention under the Mental Health (Care and Treatment) (Scotland) Act 2003 in the year following the team's introduction. The authors discuss the results and their implications.
Development of services for people with learning disabilities or mental illness in England
- Author:
- GREAT BRITAIN. Department of Health
- Publisher:
- Great Britain. Department of Health
- Publication year:
- 2010
- Pagination:
- 13p.
- Place of publication:
- London
This is the 14th report on the development of services for people with learning disabilities or mental illness in England, and highlights developments since 2003. It covers legislation, including the Mental Health Act 2007, secure services, access to psychological therapies, personality disorder, stigma and discrimination, inequalities, services for asylum seekers and refugees, the Care Programme Approach, suicide prevention, the workforce, funding, learning disabilities, and the Valuing Employment Now strategy.
The nearest relative: losing the right to concur?
- Author:
- HEWITT David
- Journal article citation:
- Journal of Adult Protection, 12(3), August 2010, pp.35-39.
- Publisher:
- Emerald
Under the Mental Health Act 1983, a person who is suffering from a mental illness may be admitted to hospital and detained there. This is only the case, however, if the person’s nearest relative has not objected to such a course. A recent High Court case examined what it means to object to detention, and may have broadened the circumstances in which an objection is deemed to have been made. The judge said that although a nearest relative might be believed not to have objected, detention will only be lawful if that belief was reasonable. He also suggested that in some cases, objection should be inferred from a nearest relative's previous conduct. This article describes the case and discusses the implications of the decision.
Newly introduced deprivation of liberty safeguards: anomalies and concerns
- Authors:
- SHAH Ajit, HEGINBOTHAM Chris
- Journal article citation:
- Psychiatrist (The), 34(6), June 2010, pp.243-245.
- Publisher:
- Royal College of Psychiatrists
This article raises concerns over irregularities within the newly introduced deprivation of liberty safeguards. The European Court of Human Rights found that the care and treatment of HL in the ‘Bournewood case’ constituted infringement, in the form of deprivation of liberty, of his rights under Articles 5 (1) and 5 (4) of the European Convention on Human Rights. To prevent the infringement, the Deprivation of Liberty Safeguards were introduced into the Mental Capacity Act 2005 via the Mental Health Act 2007. The recent implementation of the Deprivation of Liberty Safeguards on 1 April 2009 has highlighted some difficulties in its implementation and application, and these are described in this article. It concludes that many such issues may only be resolved with emerging case law.
Legal dilemmas for clinicians involved in the care and treatment of children and young people with mental disorder
- Authors:
- BOWERS M., DUBICKA B.
- Journal article citation:
- Child: Care, Health and Development, 36(4), July 2010, pp.592-596.
- Publisher:
- Wiley
This paper highlights the legal dilemmas relating to the care and treatment of under 18-year-olds for mental disorder and discusses the impact of these on clinical practice. The new legal framework is discussed with reference to hypothetical cases. Key issues outlined include age and maturity, capacity, deprivation of liberty and the zone of parental control. The authors suggest it is essential that clinicians are aware of their responsibilities within the new legal framework in order to avoid becoming a target for litigation. This paper designed to enable clinicians to meet the recommendations and to be aware of their responsibilities to engage in appropriate training.
The approved mental health professional and the nearest relative: detention need not be negligent, even if it is unlawful
- Author:
- HEWITT David
- Journal article citation:
- Journal of Adult Protection, 12(4), November 2010, pp.43-45.
- Publisher:
- Emerald
A patient may be detained under section 3 of the Mental Health Act 1983 (HM Government, 1983) only if his nearest relative does not object. Whether an objection has been made will be a question for the approved mental health professional (AMHP) concerned, but their answer will have to be a reasonable one. If the belief of the AMHP is not reasonable, a patient's section 3 admission will be unlawful. That does not mean, however, that the AMHP's conduct will necessarily be negligent, or that the patient will be entitled to damages. This article describes the case of Mr M, who remained in hospital after he was discharged from detention under the MHA, but before long was detained again under section 3. Mr M alleged that his re-detention was illegal, primarily because his nearest relative had objected to it. The judge ruled that his detention was indeed unlawful and ordered his release. Several months later, Mr M came back before the court seeking damages against the local authority who employed the AMHP. In this case the judge decided not to give permission for a damages claim, holding that even though Mr M’s detention had been unlawful ‘there is no reasonable prospect of success in any negligence claim’. This article discusses this logic of this position.
Deprivation of liberty: Mental Capacity Act safeguards versus the Mental Health Act
- Authors:
- CAIRNS Ruth, RICHARDSON Genevra, HOTOPF Matthew
- Journal article citation:
- Psychiatrist (The), 34(6), June 2010, pp.246-247.
- Publisher:
- Royal College of Psychiatrists
The European Court of Human Rights concluded that common law, which had been widely used to hold and treat patients lacking mental capacity, was inadequate to satisfy the European Convention of Human Rights. This means that if a patient lacks mental capacity and a deprivation of liberty is felt necessary to provide the care required, common law can longer be used and a choice between deprivation of liberty safeguards and the Mental Health Act must be made. However, in this short article the authors examine how the Mental Capacity Act deprivation of liberty safeguards have been criticised for their complexity and unclear interface with existing mental health law. The authors suggest that, the new legislation, which was implemented in April 2009, is likely to pose a challenge to clinical teams.
Distant voices, still lives: reflections on the impact of media reporting of the cases of Christopher Clunis and Ben Silcock
- Author:
- CUMMINS Ian
- Journal article citation:
- Ethnicity and Inequalities in Health and Social Care, 3(4), December 2010, pp.18-29.
- Publisher:
- Emerald
This article explores the way that the media reporting of two high profile cases involving mental health policy has helped to support and sustain the stereotypical view that people with mental health problems are violent. It also explores the issue of race and psychiatry via the reporting of the Inquiry into the Care and Treatment of Christopher Clunis. In addition, with the use of government papers obtained under the Freedom of Information Act, the author considers how the response to and the attempts to influence the media debate at that time helped to shape mental health policy culminating in the reform of the Mental health Act 2007 and the introduction of community treatment orders (CTOs). In the case of Ben Silcock, first reported in 1993, emphasis was on the way that mental health services had failed him and his family. In Contrast, in the case of Christopher Clunis, a 19 year old black male, which was first reported in December 1992, focus was on the failure of mental health services to protect the wider community. It is argued that the reporting of this case reflected racial and class divisions with the voice of a black working class family being effectively marginalised. The author concludes that media reporting of high profile cases has a profound influence on the development of mental health policy and that the failings in community care had a profound influence in the introduction of more coercive mental health legislation. Mental health professionals need to challenge racial stereotyping more effectively.
Checking how the Mental Health Act is used: easy read
- Author:
- CARE QUALITY COMMISSION
- Publisher:
- Care Quality Commission
- Publication year:
- 2010
- Pagination:
- 30p.
- Place of publication:
- London
This document is the easy read version of the first report into the work of the Care Quality Commission on monitoring the use of the Mental Health Act. It covers the period from April 2009 until March 2010. It describes the findings of these visits, listing aspects that need to be improved. It considers the following: taking people into hospital and keeping them there; children or young people; safe places; general hospitals; what things are like for people who are kept in hospital under the Mental Health Act; locked wards; low secure services; involving patients and looking after their rights; Independent Mental Health Advocates; Mental Health Tribunals; people being stopped, held or kept away from others; patients agreeing to treatment; Second Doctors; electro-convulsive therapy; and supervised community treatment. It concludes that services need to get better at involving patients who are kept in hospital in their care and treatment, checking whether patients understand and can agree to treatment, and treating people as individuals and making sure rules to keep people safe do not take away everyone’s rights.