Challenges faced by mental health patients and role of community

The nearest relative (NR) has proved to be a resilient feature of mental health legislation. The powers and the rules for the identification of the NR remain largely unchanged since the role was introduced in the Mental Health Act 1959, with the Mental Health Acts 1983 and 2007 only having made relatively minor modifications. The NR has even survived two attempts to abolish it, in the draft Mental Health Bills of 2002 and 2004.Few would doubt that the NR provides an important legal safeguard for the rights of mental health patients. However, the rules for establishing the identity of the NR relative are, by common consent, deeply flawed. The identification rules are rooted in the 1950s and reflect many of the assumptions about the structure and role of the family that were prevalent in the immediate post-war period. As such, they fail to reflect the lives and circumstances of mental health patients in the twenty-first century.This paper outlines, briefly, the role of the NR and the changes introduced by the Mental Health Act 2007, and the main criticisms of the rules for identifying the NR. Its main purpose, however, is to set out the reforms to those rules that were nearly achieved by the Mental Health Alliance during the passage of the Mental Health Bill 2006 and to document the ensuing Parliamentary debates. The paper concludes by considering the future of the NR.

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A legislative framework for enhancing the care and management of the mentally ill. The mental health ACT (2007) and the role of paramedics

European Psychiatry ◽

10.1016/s0924-9338(11)73338-7 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1634-1634

Author(s):

V. Parsons

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Clinical Decision Making ◽

Hospital Setting ◽

Clinical Decision ◽

Limited Attention ◽

Mental Health Patients ◽

Legislative Framework

The role of paramedics in the care and treatment of mental health patients has attracted limited attention in the research arena. With the introduction of new emergency provisions under Australian state and territory- based mental health legislation paramedics in some jurisdictions have now been granted the authority to detain, restrain, search and sedate behaviourally disturbed patients who require involuntary emergency medical assistance.The granting of mental health legislative responsibilities to paramedics has heralded a new era in not only the delivery of pre-hospital mental health care but also in the way the community perceives the role and responsibility of paramedics. The introduction of these new provisions is founded on the recognition that paramedics have a key role to play in providing high quality pre hospital mental health care. The inclusion of the provisions is also aimed at reducing the proportion of patients being handcuffed and transported to hospital by police.Drawing upon previous research which has focused on the role of paramedics in relation to mental illness (Shaban.,2005, 2006 & Roberts, 2009), this paper will detail what is currently known about mental health care in the pre-hospital setting and the clinical decision making used by paramedics when responding to mental health patients. This paper will also propose the need for further research to identify what clinical decision processes are used by paramedics when fulfilling their mental health legislative responsibilities.

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