Compulsory treatment of physical illness under MHA 1983

2021 ◽  
pp. medethics-2021-107438
Author(s):  
Robert Wheeler ◽  
Alexander Ruck Keene
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Daily Basis ◽  
Physical Illness ◽  
Compulsory Treatment ◽  
Clinical Question ◽  
Mental Health Act ◽  
Self Harm ◽  
The Law ◽  
Symptom Manifestation

Taken together, Sections 145 and 63 of the Mental Health Act 1983 (MHA) provide for treatment without consent of physical illness ancillary to the mental disorder with which a patient presents. On a daily basis, clinicians make both the decision that the Act’s authority can be applied to their patient’s case, and that it should be applied. But in the unusual circumstances where there is uncertainty as to the applicability of the MHA to the ancillary treatment of physical illness, the assistance of a court may be sought. In so doing, the law (and thence the courts) may justify compulsion but never prescribes it; the clinician is presented with authority that he or she could use but is left to decide whether it should be employed. This paper explores how the clinical question is set before the court, and whether the distinction between symptom, manifestation and consequence is sufficiently understood. This has important consequences in the context of self-neglect and its close cousin self-harm: the question whether the relevant ailment was attributable to or exacerbated by neglect or self- inflicted harm will determine whether compulsion under the MHA is applicable; and furthermore, whether or not compulsion is clinically acceptable.

scholarly journals The Law Society’s Response to the Draft Mental Health Bill

2014 ◽  
Vol 1 (12) ◽  
pp. 70
Author(s):  
Law Society
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Mental Disorder ◽  
Mental Health Act ◽  
Human Rights Act ◽  
Human Rights Act 1998 ◽  
The Law

<p>The Law Society has long campaigned for reform of the Mental Health Act 1983 (‘the 1983 Act’), which is widely recognised as out of date and not fully compatible with the Human Rights Act 1998. However the Law Society believes that the proposals contained in the Draft Mental Health Bill 2004 (‘the Bill’) are misconceived and fail to provide adequate safeguards to protect the rights of people with a mental disorder.</p>

Psychiatric emergencies

2010 ◽  
pp. 669-690
Author(s):  
Punit S. Ramrakha ◽  
Kevin P. Moore ◽  
Amir Sam
Keyword(s):  
Mental Health ◽  
Alcohol Withdrawal ◽  
Common Law ◽  
Deliberate Self Harm ◽  
Psychiatric Emergencies ◽  
Confusion Assessment ◽  
Mental Health Act ◽  
Self Harm ◽  
Acute Confusion ◽  
The Law

Acute confusion: assessment 670 Acute confusion: management 672 Acute alcohol withdrawal 674 Dealing with violent patients 676 Deliberate self-harm 678 The Mental Health Act and common law 680 Treating patients against their will 682 The law on consent and capacity 683 Patients who do not wish to stay in hospital ...

scholarly journals General practitioners' referrals for compulsory admission under the Mental Health Act, II: the process of assessment

1992 ◽  
Vol 16 (3) ◽  
pp. 139-141 ◽  
Author(s):  
Michael Sheppard
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
General Practitioners ◽  
Social Worker ◽  
Emergency Admission ◽  
Compulsory Admission ◽  
Mental Health Act ◽  
Process And Outcome ◽  
The Law ◽  
Medical Recommendations

This is the second of two articles on GP referrals for compulsory admission, and seeks to examine the process and outcome of assessment by (a) comparing GP with other section assessment referrals and (b) comparing GP referrals who were compulsorily admitted to hospital with those not compulsorily admitted or voluntarily admitted. In relation to the law the main relevant sections for this article are sections 2, 3 and 4. There are two basic grounds for admission: that the patient is suffering from a mental disorder and that admission is in the interests of his/her own health or safety or for the protection of others. Section 4 requires one and sections 2 and 3, two medical recommendations, as well as an application by an approved social worker (ASW) or nearest relative. Section 2, admission for assessment, involves admission for up to 28 days; section 4, emergency admission for assessment, involves admission for up to 72 hours; and section 3, admission for treatment, allows admission for up to six months, and is renewable.

Persuasion, Coercion, Medical Paternalism or the Mental Health Act: The Dilemma of Detention in the General Hospital

1992 ◽  
Vol 37 (5) ◽  
pp. 146-148 ◽  
Author(s):  
M S Humphreys
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
General Hospital ◽  
Physical Illness ◽  
Mental Health Act ◽  
Medical Paternalism

This paper describes the cases of three patients where the question of the need for formal detention arose due to mental disorder, apparently primarily due to physical illness, which in each case required further investigation and treatment in a general hospital. It states some of the issues facing those caring for patients under these circumstances and offers advice on overcoming some of the problems.

scholarly journals Rise in the use of section 136 of the Mental Health Act 1983 in England and Wales: A viewpoint on Loughran (2018)

2019 ◽  
Vol 60 (2) ◽  
pp. 140-146 ◽  
Author(s):  
Mark Cresswell
Keyword(s):  
Mental Health ◽  
Recent Work ◽  
Theoretical Perspective ◽  
Causal Analysis ◽  
England And Wales ◽  
Mental Health Act ◽  
The Law

This article provides a critical viewpoint on Loughran’s recent work in Medicine, Science and the Law on the causes of the rise in the police’s use of section 136 (s136) of the Mental Health Act 1983 (Loughran M. Detention under section 136: why is it increasing? Med Sci Law 2018; 58: 268–274). The rate of this rise seems significant: by 2014, it was five times more likely that a person in England would be detained in a hospital under s136 than it was in 2000, and the trend has continued to the present day. This viewpoint considers the significance of the s136 rise from the theoretical perspective of causal analysis.

Tobacco smoking and mental disorders in Australian adolescents

2021 ◽  
pp. 000486742110096
Author(s):  
David Lawrence ◽  
Sarah E Johnson ◽  
Francis Mitrou ◽  
Sharon Lawn ◽  
Michael Sawyer
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Tobacco Smoking ◽  
Mental Health Problems ◽  
Health Problems ◽  
Major Depressive ◽  
Current Smoking ◽  
Self Harm ◽  
Current Tobacco

Objectives: This study aimed to (1) examine the strength of the association between mental disorders/mental health problems, risk behaviours and tobacco smoking among Australian adolescents, (2) compare rates of tobacco smoking among Australian adolescents with major depressive disorder, attention-deficit/hyperactivity disorder and/or conduct disorder in 2013/14 vs 1998, and (3) identify the extent to which an association between tobacco smoking and mental health problems among adolescents can be attributed to non-mental health risk factors. Methods: The study utilised data from the first (1998) and second (2013/14) child and adolescent components of the National Surveys of Mental Health and Wellbeing. Both surveys identified nationally representative samples of Australian young people aged 4–17 years, living in private dwellings. Information was collected from parents and 13- to 17-year-olds about mental disorders, mental health problems, risk behaviours and tobacco smoking. Results: In the 2013/14 survey, the rate of current tobacco smoking among those with a mental disorder was 20% compared to 5% in those without a mental disorder. Rates were highest for young people with conduct disorder (50%), major depressive disorder (24%) and anxiety disorders (19%). In 2013/14, 38% of current tobacco smokers had a mental disorder and 32% reported self-harm and/or suicidal ideation vs 10% and 5%, respectively, among adolescents who had never smoked. Females with mental disorders or reporting self-harm or suicidal ideation had higher rates of current smoking than males. Other significant factors associated with current smoking included school-related problems, binge eating and having had more than one sexual partner. Conclusion: While smoking rates in 13- to 17-year-olds with mental disorders had declined since 1998, the strength of the association between mental disorders and smoking had increased, especially among females. Our findings highlight the need to address the tobacco smoking among adolescents with mental disorders, particularly females.

The Use of Section 136 of the Mental Health Act 1983 in a Family of Rural English Police Forces

2003 ◽  
Vol 43 (1) ◽  
pp. 75-79 ◽  
Author(s):  
Neil Greenberg ◽  
Niki Haines
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Police Officers ◽  
Hospital Admissions ◽  
Rural Setting ◽  
Mental Health Act ◽  
The Mean ◽  
Act Assessment ◽  
Police Forces

Section 136 of the Mental Health Act 1983 is used by police officers to detain persons who they feel might be suffering with mental disorder until a formal Mental Health Act assessment can be undertaken. Previous studies have shown that the outcomes of these assessments result in remarkably different rates of subsequent hospital admissions. Within a rural setting it has also been shown that the rate of use of Section 136 varies considerably. This study examines the use of Section 136 within a family of eight police forces that have been matched to ensure that they cover similar populations. The results show that there are considerable variations in the use of Section 136, with the Devon and Cornwall region using the section over two and a half times the mean for the group. Possible reasons for this discrepancy are discussed.

Compulsory Treatment for Anorexia Nervosa: Compassion or Coercion?

1993 ◽  
Vol 162 (5) ◽  
pp. 679-680 ◽  
Author(s):  
Jane Tiller ◽  
Ulrike Schmidt ◽  
Janet Treasure
Keyword(s):  
Mental Health ◽  
Anorexia Nervosa ◽  
Clinical Experience ◽  
Media Coverage ◽  
Compulsory Treatment ◽  
Mental Health Act ◽  
The Media ◽  
Court Of Appeal ◽  
Legal Opinion

Compulsory treatment for anorexia nervosa was recently once again a topic for discussion following the case of J, a 16-year-old girl who unsuccessfully applied to the Court of Appeal to refuse treatment for her anorexia nervosa. In this instance legal opinion was sought in order to clarify the Children Act 1989. However, much of the media coverage focused on the controversy surrounding the compulsory treatment of anorexia nervosa, under the provisions of the Mental Health Act 1983. There is a lack of research into the compulsory treatment of anorexia nervosa, so debate has to be informed by clinical experience.

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.

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