Coercion in psychiatry: is it right to involuntarily treat inpatients with capacity?

2019 ◽  
Vol 45 (11) ◽  
pp. 742-745 ◽  
Author(s):  
Harry Hudson
Keyword(s):  
Mental Health ◽  
Public Safety ◽  
Psychiatric Patients ◽  
Psychiatric Inpatients ◽  
Involuntary Treatment ◽  
The Public ◽  
Mental Health Act ◽  
The Impact ◽  
Fusion Approach

Psychiatric inpatients with capacity may be treated paternalistically under the Mental Health Act 1983. This violates bodily autonomy and causes potentially significant harm to health and moral status, both of which may be long-lasting. I suggest that such harms may extend to killing moral persons through the impact of psychotropic drugs on psychological connectedness. Unsurprisingly, existing legislation is overwhelmingly disliked by psychiatric inpatients, the majority of whom have capacity. I present four arguments for involuntary treatment: individual safety, public safety, authentic wishes and protection of autonomy. I explore these through a case study: a patient with schizophrenia admitted to a psychiatric hospital under the Mental Health Act 1983 after an episode of self-poisoning. Through its discussion of preventative detention, the public safety argument articulates the (un)ethical underpinnings of the current position in English law. Ultimately, none of the four arguments are cogent—all fail to justify the current legal discrimination faced by psychiatric inpatients. I conclude against any use of involuntary treatment in psychiatric inpatients with capacity, endorsing the fusion approach where only psychiatric patients lacking capacity may be treated involuntarily.

scholarly journals A new appraisal of Mental Health Review Tribunals

1989 ◽  
Vol 13 (6) ◽  
pp. 299-300 ◽  
Author(s):  
A. T. Grounds
Keyword(s):  
Mental Health ◽  
Psychiatric Patients ◽  
Civil Liberties ◽  
Home Office ◽  
The Public ◽  
Mental Health Act ◽  
European Court ◽  
The Right ◽  
Prime Function ◽  
Health Review

Mental Health Review Tribunals were introduced in the Mental Health Act (1959) to safeguard psychiatric patients against unjustified detention in hospital. The powers of tribunals form “an important part of the fabric of civil liberties” (Wood, 1974). However, in exercising their prime function of preventing unjust detention, tribunals in practice also have to take into account patients' clinical needs and the protection of the public. Further weight was added to this complex burden of decision making following a judgement by the European Court of Human Rights in 1981 which upheld the right of all detained patients to a periodic judicial review of their detention. As a result of this judgement the Mental Health Act (1983) extended tribunal powers to include the release of offender patients sentenced by Crown courts and given hospital orders with restrictions on discharge. Such individuals may have been convicted of grave criminal offences, and their discharge or transfer from hospital would otherwise require the consent of the Home Office.

scholarly journals The influence of selected mining and natural factors on the sinkhole creation hazard based on the case study

2021 ◽  
Vol 80 (3) ◽  
Author(s):  
Piotr Strzałkowski
Keyword(s):  
Rock Mass ◽  
Public Safety ◽  
Current Issue ◽  
Underground Mining ◽  
The Public ◽  
Natural Factors ◽  
The Subject ◽  
The Moment ◽  
The Impact

AbstractThe formation of sinkholes, especially in developed areas, constitutes a considerable hazard to the public safety. Due to the above, the subject of the paper is a significant and current issue. The paper includes a case study of sinkholes forming over shallow mine galleries. Calculations of the workings’ stability and the impact of the underground mining exploitation have been conducted. The probability of sinkhole formation has been determined as well. The time of sinkholes formation did not correspond with the time in which the mining exploitation affected the gallery workings and the moment in time for which the rock mass deformations caused by the exploitation were at the highest level. The performed exploitation caused occurrence of cracks in the rock mass over the working. This allowed the transportation of the loose overburden by rainwater to workings and as a result sinkholes were created—suffosion occurred. The Quaternary overburden built of sands and sandy loams was probably washed out by rainwater, which led to the formation of sinkholes. In all locations, where shallow voids exist at a depth up to 100 m and the overburden consists of loose rocks, one should consider the probability of sinkholes formation.

The Impact of Treatment on the Public Safety Outcomes of Mental Health Court Participants

2012 ◽  
Vol 57 (2) ◽  
pp. 231-243 ◽  
Author(s):  
Karli J. Keator ◽  
Lisa Callahan ◽  
Henry J. Steadman ◽  
Roumen Vesselinov
Keyword(s):  
Mental Health ◽  
Public Safety ◽  
Mental Health Court ◽  
The Public ◽  
Safety Outcomes ◽  
The Impact

scholarly journals Defining and Quantifying Intermittency in the Power Sector

Energies ◽  
2020 ◽  
Vol 13 (13) ◽  
pp. 3366
Author(s):  
Daniel Suchet ◽  
Adrien Jeantet ◽  
Thomas Elghozi ◽  
Zacharie Jehl
Keyword(s):  
Power Source ◽  
Production Data ◽  
Power Sector ◽  
Predictive Capacity ◽  
The Public ◽  
Current State ◽  
Definition Of ◽  
Quantitative Definition ◽  
The Impact

The lack of a systematic definition of intermittency in the power sector blurs the use of this term in the public debate: the same power source can be described as stable or intermittent, depending on the standpoint of the authors. This work tackles a quantitative definition of intermittency adapted to the power sector, linked to the nature of the source, and not to the current state of the energy mix or the production predictive capacity. A quantitative indicator is devised, discussed and graphically depicted. A case study is illustrated by the analysis of the 2018 production data in France and then developed further to evaluate the impact of two methods often considered to reduce intermittency: aggregation and complementarity between wind and solar productions.

The impact on clinical practice of the 2015 reforms to the New South Wales Mental Health Act

2016 ◽  
Vol 25 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Christopher James Ryan ◽  
Sascha Callaghan
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Clinical Practice ◽  
Persons With Disabilities ◽  
Mental Health Act ◽  
Recovery Movement ◽  
South Wales ◽  
Management Plans ◽  
Decision Making Model ◽  
The Impact

Objectives: The Mental Health Act 2007 (NSW) ( MHA) was recently reformed in light of the recovery movement and the United Nations Convention on the Rights of Persons with Disabilities. We analyse the changes and describe the impact that these reforms should have upon clinical practice. Conclusions: The principles of care and treatment added to the MHA place a strong onus on clinicians to monitor patients’ decision-making capacity, institute a supported decision-making model and obtain consent to any treatment proposed. Patients competently refusing treatment should only be subject to involuntary treatment in extraordinary circumstances. Even when patients incompetently refuse treatment, clinicians must make every effort reasonably practicable to tailor management plans to take account of any views and preferences expressed by them or made known via friends, family or advance statements.

Self-injurious behaviour in forensic mental health care: a study into the prevalence and characteristics of incidents of self-injury

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vivienne de Vogel ◽  
Nienke Verstegen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Suicide Attempts ◽  
Psychiatric Patients ◽  
Forensic Mental Health ◽  
Content Type ◽  
Self Injury ◽  
Forensic Psychiatric ◽  
The Impact

Purpose Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients. Design/methodology/approach All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+). Findings In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients. Practical implications More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self. Originality/value Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.

scholarly journals Promoting Positive Mental Health in International Postgraduate Law Students at a Time of Global Uncertainty: A Case Study from qLegal at Queen Mary, University of London

2020 ◽  
Vol 4 (2) ◽  
pp. 107-134
Author(s):  
Emily Wapples
Keyword(s):  
Mental Health ◽  
Law Students ◽  
Online Delivery ◽  
Student Mental Health ◽  
Study Approach ◽  
The Uk ◽  
Academic Consequences ◽  
Global Uncertainty ◽  
The Impact

Law student mental health and wellbeing was already a growing concern in the UK prior to COVID-19, but when the pandemic occurred, widespread uncertainty placed an unprecedented level of mental health burden on students. Law students were faced with dashed hopes, uncertain futures and the fear of negative academic consequences. This burden was exacerbated in respect of postgraduate international students in London, who were often also forced to decide whether to return home to their families, or to continue their studies abroad, albeit online. This paper uses a case study approach to discuss how one provider of postgraduate clinical legal education (CLE), approached the promotion of positive student mental health both before, and in response to, the pandemic. qLegal at Queen Mary, University of London provides CLE to postgraduates studying for a one year law masters, and in 2019-2020, qLegal delivered CLE to 134 students from 27 countries. The impact that the pandemic had on the mental health of international postgraduate law students was therefore witnessed first-hand. This paper discusses the challenges faced, and concerns raised by international postgraduate law students at qLegal as a result of the pandemic. It examines the steps taken by qLegal to maximise student engagement and promote positive student mental health when rapidly switching to a model of online delivery. The paper concludes by outlining the steps qLegal will take to monitor and address the impact that online delivery in this period of global uncertainty has on the mental health of the next cohort of postgraduate CLE students.

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