The Medicolegal Implications of the Terms ‘Psychopath’, ‘Psychopathic Personality’ and ‘Psychopathic Disorder’

1975 ◽  
Vol 15 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Donald Blair
Keyword(s):  
Mental Health ◽  
Personality Trait ◽  
Point Of View ◽  
The Other ◽  
Psychopathic Personality ◽  
Legal Responsibility ◽  
Precise Description ◽  
Subsequent Issue ◽  
Mental Health Act ◽  
Psychopathic Disorder

The difficulty in diagnosing various types of personality is considerable. What are the dividing lines between the so-called ‘ordinary personality’, ‘trend disturbances of personality’, ‘trait disorders of personality’ and ‘psychopathic disorders of personality’. There are no border lines and the qualities of one may shade into those of another. From the medicolegal point of view, however, it is obviously essential to determine which disorders of personality, if any, make sufferers not legally fully responsible for their actions. It is evident that only psychopathic disorders qualify for legal disposals that recognize their lack of legal responsibility to one degree or another. On the other hand, the latitude of interpretation of this diagnosis since it was recognized legally in the Mental Health Act 1959, has led to its use in the courts being in many cases of nebulous and doubtful value. If the conception of this entity is not to be abolished altogether there will in my estimation have to be a more exclusive and narrow meaning signified by psychopathic disorder and this article presents provocative suggestions how this may be achieved as well as a precise description of all aspects of psychopathy. The snags and illusions which have so far resulted in the mêlée of opinion regarding the whole of this matter and the influence this has had on the custodial and therapeutic disposal of this group of antisocial offenders and criminals will be discussed in a further article to be published in a subsequent issue of this journal.

Detention of In-Patients under Section 5(2) of the Mental Health Act 1983

1998 ◽  
Vol 38 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Emad Salib ◽  
Boni Iparragirre
Keyword(s):  
Mental Health ◽  
Hospital Stay ◽  
Clinical Diagnosis ◽  
Length Of Hospital Stay ◽  
The Other ◽  
Short Term ◽  
Time Of Application ◽  
Mental Health Act ◽  
Equal Chance

All applications of s.5(2) of the Mental Health Act 1983, allowing the emergency detention of voluntary in-patients in North Cheshire between 1985 and 1995, were reviewed to examine general trends in its use and to assess variables likely to influence its outcome. Of the 877 applications implemented (4% of all admissions), 500 (57%) were converted to longer-term detention under the Act, 396 (45%) were converted to s.2 and 104 (12%) to s.3. The other 377 (43%) detained patients under s.5(2) regained informal status. The review found that time of application of section, length of hospital stay prior to application, medical officer's grade, use of s.5(4) and clinical diagnosis are best predictors of s.5(2) outcome. The results are similar to other published studies and seem to reflect a national pattern, possibly implying that patients detained under this short-term detention order have an almost equal chance of either regaining their voluntary status or being detained under another section by the end of the 72 hours. This may raise questions about the purpose of s.5(2) as expressed by the Mental Health Act Commission.

scholarly journals Mental Health Act: Alleged unlawful detention

1987 ◽  
Vol 11 (7) ◽  
pp. 226-227
Author(s):  
Carmel O'Donovan
Keyword(s):  
Mental Health ◽  
Aggressive Behaviour ◽  
The Other ◽  
Consultant Psychiatrist ◽  
Mental Health Act ◽  
At Home

On several occasions in 1979 a GP member was consulted by the father and brother of a young man because they were concerned about his violent and aggressive behaviour. The GP arranged for a consultant psychiatrist to visit the patient at home on three occasions, although once he was not in and on the other two refused to see the psychiatrist and threatened him with violence.

scholarly journals Section 136 and the Police

1987 ◽  
Vol 11 (7) ◽  
pp. 224-225 ◽  
Author(s):  
John Dunn ◽  
Thomas Fahy
Keyword(s):  
Mental Health ◽  
Social Workers ◽  
Social Worker ◽  
Point Of View ◽  
Psychiatric Training ◽  
Public Place ◽  
Mentally Disordered ◽  
Police Station ◽  
Mental Health Act

Section 136 of the Mental Health Act 1983 is a controversial section. It authorises a police constable, often with no psychiatric training, to take a mentally disordered person from a public place to a place of safety, usually a hospital or a police station, so that he or she may be assessed by a doctor and a social worker within a 72 hour period. There have been several studies looking at this section from the point of view of psychiatrists, social workers, and other interested parties, in particular MIND. The aim of this study was to find out from the police whether or not problems arose during their dealings with people whom they had placed on section 136.

scholarly journals Pattern of hospital admission before and following the Mental Health Act 1983

1989 ◽  
Vol 13 (4) ◽  
pp. 182-183 ◽  
Author(s):  
S. K. Durani ◽  
R. Ford
Keyword(s):  
Mental Health ◽  
Psychiatric Practice ◽  
Duration Of Treatment ◽  
Mental Impairment ◽  
Mental Health Act ◽  
Holding Power ◽  
Assessment And Treatment ◽  
Age Limits ◽  
Definition Of ◽  
Psychopathic Disorder

The Mental Health Act brought a number of signficant changes to psychiatric practice. Among the most important were changes in the process of compulsory admissions. Other notable alterations have been a change in the definition of the nearest relative; a reduction in duration of treatment section by a half; a right to appeal against their detention by all patients; the observation section becoming an assessment and treatment section; the introduction of nurses holding power; the removal of age limits for admission of patients with psychopathic disorder and mental impairment, and the introduction of the treatability clause. These and other important differences could be expected to interact with social work and psychiatric practice to influence the number of compulsory admissions. Previous correspondence has examined this question, to which we add our findings.

Interim Hospital Order — A Regional Secure Unit experience

1994 ◽  
Vol 34 (3) ◽  
pp. 233-236 ◽  
Author(s):  
A Kaul
Keyword(s):  
Mental Health ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
Mental Health Act ◽  
Secure Unit ◽  
Psychopathic Disorder

The Mental Health Act, 1983, provides certain new provisions for the disposal of mentally disordered offenders, including the Interim Hospital Order. This Order allows the appropriateness of an eventual Hospital Order to be assessed. However, there is a wide variation in the use of the Interim Hospital Order. This paper examines the use of this Order in the Trent Regional Secure Unit, where it seems to have been used principally to assess the treatability of patients under the category of psychopathic disorder.

Detention of ‘Psychopathic Disorder’ Patients in Special Hospitals Critical Issues

1987 ◽  
Vol 151 (4) ◽  
pp. 474-478 ◽  
Author(s):  
A. T. Grounds
Keyword(s):  
Mental Health ◽  
Legal Framework ◽  
Psychological Change ◽  
Mental Health Act ◽  
Critical Issues ◽  
The Right ◽  
Special Hospitals ◽  
Reduced Risk ◽  
Psychopathic Disorder

The detention of offenders in the legal category ‘psychopathic disorder’ in special hospitals for treatment raises a number of critical issues. There are doubts about the nature of the disorder; what constitutes treatment; who is ‘treatable’; the effectiveness of treatment; and whether evidence of psychological change implies reduced risk of reoffending. In view of these uncertainties, it is argued that indeterminate hospital orders may provide an unrealistic and unjust legal framework for treating ‘psychopaths' in special hospitals, and the use of powers under the Mental Health Act to transfer such patients to hospital during the course of prison sentences is a more appropriate alternative. This provision could be used more frequently, subject to improved safeguards of the right of release at the expiry of sentence.

scholarly journals Unethical Mental Health Law; History Repeats Itself

2014 ◽  
pp. 50 ◽  
Author(s):  
A. Zigmond ◽  
A. J. Holland
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
The Other ◽  
European Convention ◽  
Green Paper ◽  
Expert Committee ◽  
Mental Health Act ◽  
Decision Making Capacity ◽  
Mental Health Legislation ◽  
Health Legislation

<p>The powers enshrined in mental health legislation go directly to fundamental principles central to any caring and democratic society. The tension and dilemma that exists is, on the one hand, the importance of respect for an individual’s right to make decision’s affecting his/her own life to, on the other, the recognition that there are people with mental disabilities that may be vulnerable to abuse and/or neglect and who throughout their lives or at particular times need care and/or treatment, which they may not seek or be able to consent to themselves. In any society it is through case law and statute that an attempt is made to resolve this tension and to ensure that individual rights are not infringed and that those who need care and treatment receive what is in their best interest. Thus a change in such legislation requires the most rigorous of examination and must be judged on the grounds that it a) does not infringe accepted principles such as those of the United Nations Declaration of Human Rights and the European Convention, b) is based on sound ethical principles and does not conflict with the established law of the country, and c) it is practicable and achieves the right balance with respect to the potential tension described above. As practising clinicians (one working in an acute psychiatric service the other in a district learning disability service) we are not in a position expertly to judge the first of these but we believe we can contribute to the second and the third. In this paper we consider specifically the reasons for, and the consequences that follow, the failure on the Government’s part to accept the central importance of decision-making capacity assessment in any new mental health legislation.</p><p>The Green Paper proposals for a new Mental Health Act for England and Wales have now been published. A broad definition of ‘mental disorder’ has been retained, a new system of tribunals is to be established and compulsory treatment in the community would become lawful. However, it rejects the recommendation of the expert committee chaired by Professor Richardson that the assessment of an individual’s decision-making capacity should be a determining factor in the use of compulsory detention. Given this, it does not address the relationship between this legislation and the proposed Mental Incapacity Act. The failure to recognise the central place of decision-making capacity in a modern Mental Health Act is, we believe, a serious omission as it is a reflection of a failure to acknowledge that the basic principle of autonomy is central to such legislation.</p>

The Operation of the Mental Health Act, 1983 (NSW)

1986 ◽  
Vol 20 (3) ◽  
pp. 278-292 ◽  
Author(s):  
Michael R. Errington
Keyword(s):  
Mental Health ◽  
Surgical Treatment ◽  
New South ◽  
New South Wales ◽  
Psychiatric Hospitals ◽  
Point Of View ◽  
Medical Practitioners ◽  
Mental Health Act ◽  
South Wales ◽  
Health Review

The Mental Health Act, 1983, and its associated legislation, effects an extensive reorganisation of the law relating to mental health in New South Wales. This paper seeks to explain the operation of the Act from the point of view of medical practitioners, for the most part medical officers and psychiatrists employed in psychiatric hospitals. Reference is also made to the rights of patients, medical and surgical treatment of patients, the property of patients and the operation of the Mental Health Review Tribunal.

A Study of Psychotropic Medication Given ‘As Required’ in a Regional Secure Unit

1990 ◽  
Vol 156 (5) ◽  
pp. 732-735 ◽  
Author(s):  
Stuart McLaren ◽  
Frederick W. A. Browne ◽  
Pamela J. Taylor
Keyword(s):  
Mental Health ◽  
Nursing Staff ◽  
Psychotropic Medication ◽  
The Other ◽  
Treatment Programme ◽  
Semistructured Interview ◽  
Mental Health Act ◽  
Patient Medication ◽  
Small Subgroup ◽  
Secure Unit

Within the setting of a regional secure unit, all doses of medication given p.r.n. over three months were ascertained and the details of each administration determined from prescription charts and a semistructured interview with the nursing staff involved. Thirty-two patients were resident for all or part of the study, all compulsorily detained. Only 15 were given medication p.r.n.) compared with the other patients they were significantly younger and more likely to be detained under civil orders than under the criminal provisions of the Mental Health Act 1983. Rarely was the medication the sole intervention in a crisis. In terms of effects on the overall treatment programme of the patient, medication given p.r.n. seemed to have an impact in only one small subgroup.

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