Controlled assessment of alcoholics admitted involuntarily to a general psychiatric hospital

1996 ◽  
Vol 13 (4) ◽  
pp. 140-143
Author(s):  
Fionnula O'Loughlin ◽  
Marcus Webb
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Alcohol Dependence ◽  
Psychiatric Hospital ◽  
Involuntary Admission ◽  
Compulsory Admission ◽  
Mental Health Act ◽  
Mental Treatment

AbstractObjective:As the provision for the involuntary admission to hospital of alcoholics is likely to be discarded in a new Irish Mental Health Act, the characteristics of patients committed under the 1945 Irish Mental Treatment Act were explored and compared with those alcoholics admitted voluntarily.Method:All alcoholics admitted compulsorily from 1989-1992 to a general psychiatrichospital in Dublin were compared retrospectively with voluntarily admitted alcoholics. Data was taken from case notes.Results:Results showed that patients admitted compulsorily were older (t = 3.74, df = 62, p < 0.001) and had more physical complications (X2= 8.4, df = 1, p < 0.004) than those admitted voluntarily. Although results did not reach a statistically significant level, there were proportionately more females in the compulsorily admitted group compared with the voluntary group. The outcome of admission overall was better in those admitted voluntarily, although this was influenced both by length of stay and previous admissions for treatment of alcohol dependence. One particularly interesting finding, regardless of admission category, was that duration of admission was statistically significantly longer for women when compared with men.Conclusions:Compulsory admission of alcoholics to a psychiatric hospital for very brief periods was not shown to be strikingly helpful, but this study cannot decide whether or not longer periods of compulsory admission would be valuable.

scholarly journals Irish Mental Health Act 2001: impact on involuntary admissions in a community mental health service in Dublin

2010 ◽  
Vol 34 (10) ◽  
pp. 436-440 ◽  
Author(s):  
Izu Nwachukwu ◽  
Niall Crumlish ◽  
Elizabeth A. Heron ◽  
Michael Gill
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Clinical Implications ◽  
Community Mental Health Service ◽  
Involuntary Admission ◽  
Mental Health Act ◽  
Psychiatric Admissions ◽  
More Care ◽  
Mental Treatment ◽  
The Impact

Aims and methodOn 1 November 2006, Ireland's Mental Health Act 2001 was implemented, replacing the country's Mental Treatment Act 1945. We aimed to assess the impact of this change in legislation on the number and duration of involuntary admissions. We undertook a retrospective review of all admissions to a psychiatric admissions unit from January to October 2006 (pre-implementation) and January to October 2007 (post-implementation).ResultsThere were 46 involuntary admissions in the 10-month period under study in 2006, or 33.8 per 100 000 population. There were 53 in 2007, or 39.3 per 100 000 population. This increase was not significant (z = – 0.7, P = 0.46), however involuntary admissions formed a larger proportion of all admissions under the Mental Health Act 2001 than under the Mental Treatment Act 1945 (χ2 = 4.2, P =0.04). There was no difference in the duration of involuntary admissions but under the 2001 Act, involuntary patients had longer periods of voluntary status as part of their admissions than under the 1945 Act.Clinical implicationsThe introduction of more rigorous procedures for involuntary admission did not significantly change the rate or duration of involuntary admissions in our centre. The finding that involuntary admissions included longer periods of voluntary status suggests that more care is being taken to revoke involuntary admission orders under the Mental Health Act 2001 than under the Mental Treatment Act 1945.

First Compulsory Admissions under Part II of the Mental Health Act 1983: A retrospective five-year study

2003 ◽  
Vol 43 (3) ◽  
pp. 248-254 ◽  
Author(s):  
R Law-Min ◽  
F Oyebode ◽  
M S Haque
Keyword(s):  
Mental Health ◽  
Psychiatric Hospital ◽  
Compulsory Admission ◽  
Mental Health Act ◽  
Psychiatric Admissions ◽  
Co Morbidity ◽  
Asian Men ◽  
African Caribbean ◽  
The Mean ◽  
First Time

The aim was to explore what happened during a five-year period to a group of patients with no previous psychiatric admissions, who were detained for the first time in a psychiatric hospital under part II of the Mental Health Act 1983. Subjects (n=189) who were detained under Section 2 or 3 in 1996 and 1997 in Queen Elizabeth Psychiatric Hospital, Birmingham were identified from computerised inpatient admission records. The mean age was 40.0 years (range 21-65). Nearly half of the cohort had a diagnosis of psychoses. Asians had the highest proportion of psychoses (64%) compared to African-Caribbean patients (48%) and White patients (41%). Almost half of the sample had a further admission, with Asian and African-Caribbean patients more likely to be readmitted than their white counterparts. Nearly a third of the cohort had a further compulsory detention. On re-admission, African-Caribbean subjects were more likely to be detained compared to Asian and White subjects. Fifty per cent had a further compulsory admission within a year of the index admission. The high number of psychoses in the Asian group may be due to their psychosis being more serious at presentation as a result of denial of illness and an increased co-morbidity with drug use in Asian men.

scholarly journals Mental Health Act reform

1999 ◽  
Vol 23 (10) ◽  
pp. 578-581 ◽  
Author(s):  
Trevor Turner ◽  
Mark Salter ◽  
Martin Deahl
Keyword(s):  
Mental Health ◽  
Medical Profession ◽  
Medical Model ◽  
Chief Executive ◽  
Radical Change ◽  
Medical Decision ◽  
Mental Health Act ◽  
Consent To Treatment ◽  
Mental Treatment ◽  
Health Legislation

Psychiatrists have been complaining about mental health legislation for over a century (Smith, 1891), usually in terms of the delays engendered, paperwork and bureaucracy, and the impositions on clinical practice. As a result they have gained more powers, and perhaps much-needed status within the medical profession, to the concern of some commentators (e.g. Fennell, 1996). Thus, the ‘triumph of legalism’ (Jones, 1993) of the Lunacy Act 1890 was modified by the Mental Treatment Act 1930, whereby outpatients and voluntary patients were encouraged and ‘asylums' became ‘mental hospitals'. Then came the radical change of the Mental Health Act (MHA) 1959, making compulsory detention an essentially medical decision and removing the routine of the courts, but retaining a theme of requiring ‘treatment in hospital’. The Mental Health Act 1983, however, was a touch anti-medical, since it strengthened the role of the approved social worker (ASW) and enhanced the importance of a patient's consent to treatment. “The primacy of the medical model and the paramountcy of the psychiatrist are certainly subject to greater limitations and external review”, was the opinion of William Bingley, then Mind's Legal Director, now Chief Executive of the Mental Health Act Commission – reviewing the Act in its early days (Bingley, 1985).

scholarly journals Coercive Measures and Stigmatization in the Psychiatric Medical Care

2020 ◽  
Vol 11 (3sup1) ◽  
pp. 137-145
Author(s):  
Petronela Nechita ◽  
◽  
Liliana Luca ◽  
Alina-Ioana Voinea ◽  
Codrina Moraru ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychiatric Disorders ◽  
Psychiatric Hospital ◽  
Treatment Compliance ◽  
Mental Illnesses ◽  
Internal Conflict ◽  
Involuntary Admission ◽  
Coercive Measures ◽  
Self Harm ◽  
The Law

The involuntary commitment of psychiatric patients has been done for almost a decade under the Law 487/2002, the law of mental health and protection for people with psychiatric disorders. Frequent involuntary psychiatric hospitalizations have led to stigma attitudes and discriminatory acts towards patients with mental disorders. The coercive medical measures are applied in the psychiatric institutions of the mental health protection agencies. Coercion gives rise to serious ethical debates in the psychiatric assistance. The individual who was hospitalized in a psychiatric hospital anticipates social rejection becoming defensive, withdraws socially, experiences a complex internal conflict. The goal for this study is to illustrate aspects linked to coercive measures, mechanical restraint at involuntary admission of patients with mental illnesses in the psychiatric medical assistance. Material and method: This study is a retrospective one, and the data was taken from the charts with involuntary admissions during the period of October 2002 to July 2012. The studied lot was comprised of 202 patients admitted involuntarily in a psychiatric hospital according to the Law 487/2002, the law of mental health and protection for people with psychiatric disorders. Results: Of the 25.7% patients admitted involuntarily, that required coercive measures during admission, 58% were contained for symptoms like self-harm. The mechanical contention measures were especially necessary in the acute cases with symptoms as self-harm and/or harm of others, but also in situations with hallucinatory-delirium symptoms. The ratio of male sex subjects was significantly higher in the subject lot that needed coercive measures during hospitalization, of those admitted involuntarily (86.5% vs. 72%) (p = 0.036). Conclusions: Involuntary admission and mandatory treatment remains in psychiatry a medical, legal and ethical problem. The required measures can lead mainly to clinical benefits, implying a paternal attitude from the psychiatry specialists by defying the patients’ autonomy. Treatment compliance is directly proportional to the overall level of functioning and inversely proportional to the level of self-stigmatization.

The law

2009 ◽  
pp. 459-498
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Compulsory Admission ◽  
Sexual Offences ◽  
Disability Discrimination ◽  
Mental Health Act ◽  
Assessment And Treatment ◽  
Human Rights Act ◽  
Disability Discrimination Act ◽  
Health Review

Mental Health Act 1983 460 Mental Health Act 2007 462 Compulsory admission to hospital for assessment and treatment 464 Emergency holding powers 466 Mental Health Review Tribunals 468 The Mental Health Act Commission 470 Sexual Offences Act 472 Disability Discrimination Act 2005 474 Human Rights Act ...

Assessment of Suicide Risk

1987 ◽  
Vol 150 (2) ◽  
pp. 145-153 ◽  
Author(s):  
K. Hawton
Keyword(s):  
Mental Health ◽  
Psychiatric Disorders ◽  
Psychiatric Hospital ◽  
Suicide Risk ◽  
Clinical Skills ◽  
Clinical Decisions ◽  
Suicide Attempters ◽  
Mental Health Act ◽  
Hospitalised Patients ◽  
The Many

Among the many clinical skills that psychiatrists must acquire, the ability to assess the risk of patients killing themselves is probably the most important and demanding. It is often a crucial factor when making clinical decisions, such as in the choice of treatments, when deciding whether admission to a psychiatric hospital is necessary and when implementing the Mental Health Act. This review first explores the problems in assessing suicide risk. Subsequently, the risks of suicide for patients with major psychiatric disorders and for particular clinical populations, including hospitalised patients and suicide attempters, are examined together with the findings from research investigations which can assist psychiatrists when making decisions about the risk of suicide.

Involuntary admissions to a district mental health service – implications for a new mental treatment act

1993 ◽  
Vol 10 (3) ◽  
pp. 139-144 ◽  
Author(s):  
Teresa G Carey ◽  
John M Owens
Keyword(s):  
Mental Health ◽  
Retrospective Study ◽  
Mental Health Service ◽  
Civil Rights ◽  
Psychiatric Service ◽  
Case Note ◽  
Compulsory Admission ◽  
Access To Treatment ◽  
Mental Treatment ◽  
One Year

AbstractObjective: The aim of this study was to examine the working of the 1945 Irish Mental Treatment Act in relation to compulsory admission and detention and to establish issues that will need to be addressed in imminent new legislation. Method: A 3 year retrospective study was carried out on all compulsory admissions to the Cavan/Monaghan Psychiatric Service using case note material. The circumstances surrounding application for compulsory admission in one year of the study period were further investigated by delivery of a schedule to Relative-Applicants. Results: The study revealed rates of compulsory admission equivalent to other Irish regions but much higher than neighbouring jurisdictions. There was no evidence of deliberate abuse of the act. Indications emerged of excessive and inappropriate recourse to certification by some relatives and General Practitioners. Excessive length of detained stay and lack of specific procedures for informing patients of their rights were evident. Conclusions: A new Mental Treatment Act will need to place much greater emphasis on patients' civil rights while facilitating access to treatment.

Clinical predictors of involuntary detention among voluntary inpatients in St Patrick’s University Hospital (SPUH)

2015 ◽  
Vol 34 (1) ◽  
pp. 13-18
Author(s):  
B. Masood ◽  
S. O’Ceallaigh ◽  
T. Thekiso ◽  
M. Nichol ◽  
P. Kowalska-Beda ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicide Risk ◽  
Clinical Characteristics ◽  
University Hospital ◽  
Involuntary Admission ◽  
Clinical Predictors ◽  
Consultant Psychiatrist ◽  
Mental Health Act ◽  
Admission Status ◽  
Act Assessment

BackgroundFew studies have described clinical characteristics of patients subject to an involuntary detention in an Irish context. The Irish Mental Health Act 2001 makes provision under Section 23(1), whereby a person who has voluntary admission status can be detained.AimsThis study aimed to describe all involuntary admissions to St Patrick’s University Hospital (SPUH) (2011–2013) and to evaluate clinical characteristics of voluntary patients who underwent Mental Health Act assessment during 2011 to determine differences in those who had involuntary admission orders completed and those who did not.MethodsAll uses of Mental Health Act 2001 within SPUH 2011–2013 were identified. All uses of Section 23(1) during 2011 were reviewed and relevant documents/case-notes examined using a pro forma covering clinical data, factors recognized to influence involuntary admissions and validated scales were used to determine diagnoses, insight, suicide and violence risk.ResultsOver 2011–2013, 2.5–3.8% of all admissions were involuntary with more detained after use of Section 23(1) than Section 14(2). The majority of initiations of Section 23(1) did not result in an involuntary admission (72%), occurred out of hours (52%) and many occurred early after admission (<1 week, 43%). Initiation of Section 23(1) by a consultant psychiatrist (p=0.001), suicide risk (p=0.03) and lack of patient insight into treatment (p=0.007) predicted conversion to involuntary admission.ConclusionThis study predicts a role for patient insight, suicide risk and consultant psychiatrist decision making in the initiation of Mental Health Act assessment of voluntary patients. Further data describing the involuntary admissions process in an Irish setting are needed.

The development of the role in Ireland of the Authorised Officer (Section 9:1b Mental Health Act 2001) applicant for the involuntary admission to approved centres of persons suffering from mental disorders

2015 ◽  
Vol 32 (4) ◽  
pp. 353-358 ◽  
Author(s):  
F. J. Browne
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Health Service ◽  
Involuntary Admission ◽  
Health Service Executive ◽  
Mental Health Act

This article outlines the development of the role of the Health Service Executive Authorised Officer in Ireland, the professional applicant for the involuntary admission of an adult to hospital beyond that which was envisioned in the Mental Health Act 2001.

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