scholarly journals MENTAL HEALTH ACT, MALTA 2012 - A personal reflection on 5 years working with a new legal framework

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
J M Cachia
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Planning Process ◽  
Community Support ◽  
Critical Issue ◽  
Community Treatment ◽  
Care Process ◽  
Care Plans ◽  
Mental Health Act ◽  
Involuntary Care

Abstract The Commissioner for the Promotion of Rights of Persons with Mental Disorders (CMH) was established in Article 5 of the Mental Health Act approved by the Maltese Parliament in December 2012. The whole Act was completely in force on 10th October 2014. The involuntary care process is being closely monitored. Patients are being followed up within the time-frames established by the new law. Although not strictly comparable, length of stay in involuntary care has diminished radically. Patients are being discharged from compulsory treatment orders or transferred to community treatment orders rather than being left on “leave of absence”. Community involuntary care is the preferred option of following up difficult cases. This shift requires commitment to strengthen community support services and render them sustainable. The applications for involuntary care are progressively being better completed and the quality of the information backing requests for involuntary detention of persons is improving. Care plans are being submitted, but their completeness and their quality merits revision. The issue of availability of human resources is a critical issue which regularly features in feedback with care teams. Evidence of greater involvement of patients and responsible carers in the care planning process should be better documented if it is indeed happening. The level of awareness of patients’ rights in terms of the Act merits deeper evaluation. The CMH must continue to provide a voice to vulnerable persons with mental disorders and their loved ones. Maximization of the potential of persons with mental disorders is not only a question of social justice but also critical for the sustainability of our health system and the prosperity of our society. The burden of mental disorders is increasing exponentially with the modernization of our society and those who are not coping with this burden merit active consideration and support. Key messages Public health advocacy and the improvement of patient rights. The use of legislative tools in reforming service delivery.

scholarly journals Impact of introducing capacity-based mental health legislation on the use of community treatment orders in Norway: case registry study

BJPsych Open ◽  
2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Georg Høyer ◽  
Olav Nyttingnes ◽  
Jorun Rugkåsa ◽  
Ekaterina Sharashova ◽  
Tone Breines Simonsen ◽  
...  
Keyword(s):  
Mental Health ◽  
Incidence Rates ◽  
Community Treatment ◽  
Prevalence Rates ◽  
Community Treatment Orders ◽  
Retrospective Case ◽  
Case Register ◽  
Mental Health Act ◽  
Catchment Areas ◽  
Involuntary Care

Background In 2017, a capacity-based criterion was added to the Norwegian Mental Health Act, stating that those with capacity to consent to treatment cannot be subjected to involuntary care unless there is risk to themselves or others. This was expected to reduce incidence and prevalence rates, and the duration of episodes of involuntary care, in particular regarding community treatment orders (CTOs). Aims The aim was to investigate whether the capacity-based criterion had the expected impact on the use of CTOs. Method This retrospective case register study included two catchment areas serving 16% of the Norwegian population (aged ≥18). In total, 760 patients subject to 921 CTOs between 1 January 2015 and 31 December 2019 were included to compare the use of CTOs 2 years before and 2 years after the legal reform. Results CTO incidence rates and duration did not change after the reform, whereas prevalence rates were significantly reduced. This was explained by a sharp increase in termination of CTOs in the year of the reform, after which it reduced and settled on a slightly higher leven than before the reform. We found an unexpected significant increase in the use of involuntary treatment orders for patients on CTOs after the reform. Conclusions The expected impact on CTO use of introducing a capacity-based criterion in the Norwegian Mental Health Act was not confirmed by our study. Given the existing challenges related to defining and assessing decision-making capacity, studies examining the validity of capacity assessments and their impact on the use of coercion in clinical practice are urgently needed.

A retrospective cohort study describing characteristics of those repeatedly detained under Section 136 of the Mental Health Act over a 5-year period and the association with past abuse

2021 ◽  
pp. 002580242110454
Author(s):  
Laureen Adewusi ◽  
Isabel Mark ◽  
Paige Wells ◽  
Aileen O’Brien
Keyword(s):  
Mental Health ◽  
Past History ◽  
Significant Proportion ◽  
Community Support ◽  
White Ethnicity ◽  
Demographic Profiles ◽  
Mental Health Act ◽  
History Of ◽  
Self Harm ◽  
The Uk

Individuals repeatedly detained under Section 136 (S136) of the Mental Health Act account for a significant proportion of all detentions. This study provides a detailed analysis of those repeatedly detained (‘repeat attenders’) to a London Mental Health Trust, identifying key demographic profiles when compared to non-repeat attenders, describing core clinical characteristics and determining to what degree a past history of abuse might be associated with these. All detentions to the S136 suite at South West London and St George's Mental Health NHS Trust over a 5-year period (2015–2020) were examined. Data were collected retrospectively from electronic records. A total of 1767 patients had been detained, with 81 patients identified as being a ‘repeat attenders’ (having had > = 3 detentions to the S136 suite during the study period). Repeat attenders accounted for 400 detentions, 17.7% of all detentions. Repeat attenders included a higher proportion of females (49.4%, p = 0.0001), compared to non-repeat attenders, and a higher proportion of them were of white ethnicity (85.2%, p = 0.001). 52 (64%) patients reported being a victim of past abuse or trauma. Of repeat attenders who reported past abuse or trauma, a high proportion had diagnoses of personality disorders, with deliberate self-harm as the most common reason for detention. They were more commonly discharged home with community support, rather than considered for hospital admission. In light of these findings, this paper discusses support potential strategies for those most vulnerable to repeated S136 detention, thereby minimising the ever-growing number of S136 detentions in the UK.

7. Mental Health Law

Medical Law ◽  
2019 ◽  
pp. 351-419
Author(s):  
Emily Jackson
Keyword(s):  
Mental Health ◽  
Community Treatment ◽  
Health Law ◽  
Persons With Disabilities ◽  
Mental Health Law ◽  
Mental Health Act ◽  
Independent Review ◽  
History Of ◽  
Human Rights Act ◽  
The Uk

All books in this flagship series contain carefully selected substantial extracts from key cases, legislation, and academic debate, providing able students with a stand-alone resource. This chapter discusses mental health law in the UK. It begins with a brief history of mental health law and policy. This is followed by discussions of: admission to the mental health system; treatment of the mentally ill under the Mental Health Act 1983; Deprivation of Liberty Safeguards (DoLS) and Cheshire West, and Community Treatment Orders. It also looks at the implications of the Human Rights Act and the UN Convention on the Rights of Persons with Disabilities (UNCRPD) for mental health law. It also considers the conclusions of the Independent Review of the Mental Health Act 1983.

scholarly journals Mental health law in Ghana

2017 ◽  
Vol 14 (2) ◽  
pp. 38-39 ◽  
Author(s):  
George Hudson Walker ◽  
Akwasi Osei
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Health System ◽  
Mental Health System ◽  
Mental Healthcare ◽  
Health Law ◽  
Community Based ◽  
Mental Health Law ◽  
Mental Health Act ◽  
New System

In 2012 Ghana passed a new Mental Health Act, which aimed to create a new system of mental healthcare in Ghana. The Act includes provisions for the creation of a modern, community-based mental health system and for the protection of the rights of persons with mental disorders. This article discusses the implications of the Act and the progress which has been made towards its implementation.

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.

scholarly journals Community Treatment Orders

2014 ◽  
Vol 1 (16) ◽  
pp. 149
Author(s):  
Kris Gledhill
Keyword(s):  
Mental Health ◽  
Revolving Door ◽  
Community Treatment ◽  
Patient Treatment ◽  
England And Wales ◽  
Mental Health Act ◽  
Heated Debate ◽  
Policy Objectives ◽  
Treatment Order ◽  
Community Treatment Order

<p>A community treatment order is now a well-established feature of various common law jurisdictions in North America and Australasia, and in other countries. Its introduction into England and Wales was a central part of the government’s drawn out reform of the Mental Health Act 1983, and it attracted heated debate as part of the Parliamentary process, both in the exchanges between Parliamentarians and the evidence and briefings filed by interested parties. A CTO provision was introduced with a speedier gestation period in Scotland. But there is no single form of “community treatment order”; and there may also be different policy objectives. What is usually central is the desire to provide a regime for patients who are assessed as being able to function in the community so long as they accept medication but who may disengage from treatment and relapse to the extent that they require in-patient treatment: the description “revolving door” is often attached to such patients and was during the course of the debates.</p><p>The first question to be explored is whether what emerged in the Mental Health Act 2007 is much different from what already exists in relation to such patients: if it is and it allows community treatment which was previously not available, the further question is whether that is a good thing in light of the experience of other jurisdictions that have CTO regimes. If it is not, there are two further questions: firstly, why has something called a CTO been introduced if it does not amount to a change of substance; and secondly, is it a missed opportunity in light of the information from other jurisdictions – in other words, would a substantive change provide benefits which England and Wales is now missing?</p>

scholarly journals This strange republic of the good: Community treatment orders and their conditions

2014 ◽  
pp. 39 ◽  
Author(s):  
David Hewitt
Keyword(s):  
Mental Health ◽  
Health Professional ◽  
Mental Health Professional ◽  
Community Treatment ◽  
Community Treatment Orders ◽  
Mental Health Act ◽  
Treatment Order ◽  
Community Treatment Order

The Community Treatment Order (CTO) was introduced by the Mental Health Act  2007, and from the start, it was controversial. There is evidence that even the principle of community compulsion was opposed by a majority of psychiatrists, and it was said that many would resign rather than implement CTOs. Happily, that prediction has not been realised. In fact, it seems that many psychiatrists, and more than one Approved Mental Health Professional (AMHP), have seized upon CTOs with something approaching alacrity.

scholarly journals Changes to the Mental Health and Mental Capacity Acts: implications for patients and professionals

2009 ◽  
Vol 33 (6) ◽  
pp. 226-230 ◽  
Author(s):  
Ian Hall ◽  
Afia Ali
Keyword(s):  
Mental Health ◽  
Work Load ◽  
Mental Capacity ◽  
Community Treatment ◽  
Mental Health Act ◽  
Mental Capacity Act 2005 ◽  
User Groups ◽  
Treatment Changes ◽  
Mental Capacity Act

SummaryThe new Mental Health Act 2007 for England and Wales has introduced substantial amendments to the 1983 Mental Health Act and has also amended the Mental Capacity Act 2005. Most provisions came into effect in November 2008. the introduction of supervised community treatment, changes to professional roles such as the role of ‘responsible clinician’, and the introduction of deprivation of liberty safeguards in the Mental Capacity Act are discussed. Many of the new safeguards in the Act are welcomed by clinicians and service user groups. However, other changes are more controversial and could potentially lead to an increase in the work load of clinicians.

scholarly journals Compulsion in the community? The introduction of supervised community treatment

2010 ◽  
Vol 16 (4) ◽  
pp. 245-252 ◽  
Author(s):  
Guy Brookes ◽  
Nick Brindle
Keyword(s):  
Mental Health ◽  
Health Professionals ◽  
Community Treatment ◽  
Mental Health Practitioners ◽  
England And Wales ◽  
Mental Health Act ◽  
Health Practitioners ◽  
Legislative Framework

SummarySupervised community treatment (SCT) is one of the most prominent amendments to the Mental Health Act 1983. It has divided opinion among health professionals and introduces significant powers not previously available in England and Wales. This article considers how SCT fits into the established legislative framework and how it may affect the care delivered by mental health practitioners.

scholarly journals Impact of Co-occurring Mental Disorders and Chronic Physical Illnesses on Frequency of Emergency Department Use and Hospitalization for Mental Health Reasons

2021 ◽  
Vol 12 ◽  
Author(s):  
Lia Gentil ◽  
Guy Grenier ◽  
Xiangfei Meng ◽  
Marie-Josée Fleury
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Mental Disorders ◽  
Service Use ◽  
Negative Binomial ◽  
Age Groups ◽  
Community Treatment ◽  
Care Services ◽  
Wide Range ◽  
Estimated Risk

Background: Patients with mental disorders (MD) are at high risk for a wide range of chronic physical illnesses (CPI), often resulting in greater use of acute care services. This study estimated risk of emergency department (ED) use and hospitalization for mental health (MH) reasons among 678 patients with MD and CPI compared to 1,999 patients with MD only.Methods: Patients visiting one of six Quebec (Canada) ED for MH reasons and at onset of a MD in 2014–15 (index year) were included. Negative binomial models comparing the two groups estimated risk of ED use and hospitalization at 12-month follow-up to index ED visit, controlling for clinical, sociodemographic, and service use variables.Results: Patients with MD, more severe overall clinical conditions and those who received more intensive specialized MH care had higher risks of frequent ED use and hospitalization. Continuity of medical care protected against both ED use and hospitalization, while general practitioner (GP) consultations protected against hospitalization only. Patients aged 65+ had lower risk of ED use, whereas risk of hospitalization was higher for the 45–64- vs. 12–24-year age groups, and for men vs. women.Conclusion: Strategies including assertive community treatment, intensive case management, integrated co-occurring treatment, home treatment, and shared care may improve adequacy of care for patients with MD-CPI, as well as those with MD only whose clinical profiles were severe. Prevention and outreach strategies may also be promoted, especially among men and older age groups.

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