The Decision by Approved Mental Health Professionals to Use Compulsory Powers under the Mental Health Act 1983: A Foucauldian Discourse Analysis

2014 ◽  
Vol 46 (1) ◽  
pp. 46-62 ◽  
Author(s):  
Rosie Buckland
2020 ◽  
Vol 50 (2) ◽  
pp. 616-633 ◽  
Author(s):  
Michael Bonnet ◽  
Nicola Moran

Abstract The number of people detained under the 1983 Mental Health Act has risen significantly in recent years and has recently been the subject of an independent review. Most existing research into the rise in detentions has tended to prioritise the perspectives of psychiatrists and failed to consider the views of Approved Mental Health Professionals (AMHPs), usually social workers, who ultimately determine whether detention is appropriate. This mixed-methods study focused on AMHPs’ views on the reasons behind the rise in detentions and potential solutions. It included a national online survey of AMHPs (n = 160) and semi-structured interviews with six AMHPs within a Community Mental Health Team in England. AMHPs reported that demand for mental health services vastly exceeded supply and, due to inadequate resources, more people were being detained in hospital. AMHPs argued that greater investment in preventative mental health services and ‘low intensity’ support would help to mitigate the impact of social risk factors on mental health; and greater investment in crisis services, including non-medical alternatives to hospital, was required. Such investment at either end of the spectrum was expected to be more effective than changes to the law and lead to better outcomes for mental health service users.


2019 ◽  
Vol 4 (4) ◽  
pp. 88-93
Author(s):  
Arun Sondhi ◽  
Emma Williams

Detention under section 136(1) of the Mental Health Act 1983 allows for the police to detain a person from a public place and “remove [them] to a place of safety” if it is “in the interests of that person or for the protection of other persons in immediate need of care or control.” This study examines the interface between police and health professionals covering the conveyance and transfer of detainees to a place of safety and on completion of the assessment prior to inpatient admission. One hundred ninety-six professionals were interviewed across police (n=38), London Ambulance Service (n=2), Mental Health or Emergency Department staff (n=63), and Approved Mental Health Professionals (AMHPs)/Section 12 doctors (n=93). The data was analyzed thematically using a Framework analysis. The conveyance and transfer of detainees was framed by various elements of detainee risk. Healthcare professionals cited clinical risk, risk associated with substance misuse, professional safety, culture of risk aversion, staffing issues, and fear of certain detainee groups as the main issues. For police, risk was discussed within the context of institutional or professional fear of negligence due to an adverse incident. It is argued that the negative framing of risk at this point of the detention process by all professionals creates a negative therapeutic environment for detainees. Whilst safety is an essential part of the detention process, these distinctions problematize the process for a detainee. The article argues for a more balanced framing of risk to establish a more therapeutic interaction between detainees and police and healthcare providers.


2014 ◽  
Vol 1 (10) ◽  
pp. 35
Author(s):  
Kris Gledhill

<p align="LEFT">The Mental Health Act 1983 provides for detention and also for treatment which would otherwise be an assault. As such, it allows for interference with the fundamental rights to liberty and to self-determination. Particularly as it does so in the context of a branch of medicine which is often highly subjective, it is hardly surprising that litigation is occasionally resorted to by those affected who wish to challenge the legality of what is occurring to them.</p><p align="LEFT">The framework for this litigation has developed, spurred on in particular by the growth of public law and human rights law. As a result, mental health professionals have to be familiar not just with the court-machinery which is central to the Mental Health Act 1983 (which provides for the Mental Health Review Tribunal to determine the legality of the ongoing detention of a patient, and refers the issue of the displacement of a nearest relative to the county court) but also with the courts which deal with questions of public law (in particular the Administrative Court) and the civil litigation courts.</p>


2007 ◽  
Vol 13 (5) ◽  
pp. 350-357 ◽  
Author(s):  
Kalpana Dein ◽  
Paul Simon Williams ◽  
Simon Dein

There is evidence pointing to a bias in the application of the Mental Health Act 1983 (which is in force in England and Wales). One study found that Black people on in-patient units were four times more likely to have been compulsorily admitted than White people. Furthermore, it has been shown that compulsory admissions to secure units are 2.9–5.6 times higher for Black than for White patients. Any understanding of this bias necessitates an examination of the attitudes of mental health professionals towards Africans and African–Caribbeans. Here we discuss possible contributory factors and examine a number of initiatives that have been instituted in order to tackle this problem.


Linguistics ◽  
2019 ◽  
Author(s):  
Dennis Tay

Mental health disorders are conditions that disturb thought, mood, behaviors, or combinations of all three. Familiar examples include depression, bipolar disorder, posttraumatic stress disorder, and schizophrenia. Although symptoms range from mild to severe, they generally affect an individual’s ability to function in daily life and are more common in the 2010s than popularly assumed, according to reporting by the World Health Organization. Language in mental health disorders has been researched in two broad strands. First, many of them are treated by the verbal activity of psychological counseling (or psychotherapy), sometimes called the “talking cure.” Therapists apply clinical methods and interact with clients over multiple sessions to understand and modify their behaviors, cognitions, and emotions. On the one hand, this type of interaction provides rich data for linguists working in sociolinguistics, conversation analysis, (critical) discourse analysis, and pragmatics to investigate the linguistic nature of a socially important activity. On the other hand, a growing number of mental health professionals acknowledge the relevance of linguistic research and offer similar analyses from more clinically oriented perspectives. Both groups of researchers employ diverse methodologies, including discourse analysis, corpus, survey, and (quasi)-experimental techniques on different levels of linguistic phenomena, from words to rhetorical devices such as metaphor. While research into the language of psychotherapy generally assumes that clients have intact language and communication skills that support the treatment process, the second research strand examines the relationships between specific mental health diagnoses and language-related symptoms. Trauma patients, for instance, suffer a loss of ability to produce coherent narratives of their traumatic experiences. Whether language is seen as a treatment resource or target of affliction, one can identify fairly distinct descriptive or prescriptive/interventionist foci in the literature. Descriptively oriented studies are more common in linguistics research and have the fundamental aim of documenting characteristics of language in the underexplored context of mental health. The general assumption of such studies is that all social contexts of language use are of inherent interest. Therefore, research is not primarily aimed at improving how the activities underlying these contexts are conducted; that is, better treatment outcomes. In contrast, prescriptive or interventionist studies are more common in psychological and mental health research. The emphasis is not on understanding linguistic properties, but on the relationship between language variables and treatment processes or outcomes. A survey of both literatures, however, reveals an encouraging movement toward some meeting point in between, and closer collaborative work among linguists and mental health professionals. The growing number of synergistic research resources and publication outlets also reflects this.


1994 ◽  
Vol 18 (6) ◽  
pp. 328-332 ◽  
Author(s):  
Christopher Curran ◽  
William Bingley

The aim of this article is to promote a clearer understanding of the Mental Health Commission's development, structure and function. Over recent years, mental health professionals and patients have become more aware of the organisation and its work, although some may remain uncertain about its function and how it fits into the overall care of detained patients. The Commission's fundamental job is to safeguard the well-being and interests of patients detained under the Act. Its remit does not extend to informal patients. Unless otherwise indicated, all statutory references are to the 1983 Mental Health Act.


2021 ◽  
pp. 104973232110368
Author(s):  
Andrew Gumley ◽  
Angela Glasgow ◽  
Gordon McInnes ◽  
Calum Jackson

Advance Statements enable mental health patients to have their preferences considered in treatment decisions in the event of losing capacity, but their uptake is poor. This is for complex and often conflicting reasons and factors related to service user, clinician, and institutional priorities, which influence clinical practice. A Foucauldian discourse analysis approach was used to explore how 13 mental health clinicians positioned their role in relation to Advance Statements. Five positions emerged from the data: taking account of peoples’ wishes, enabling people to have their say (to a point), we know what’s best, firefighting with risk, and leverage and liability. Discursive practices demonstrated and reinforced power relations between patients, clinicians, and wider systems. These findings highlight the challenge of legitimizing the knowledge of patients and need for a cultural shift at a systems level, which recognizes the ways Advance Statements meet the needs of all stakeholders.


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