Patterns of use of the Mental Health Act 1983, from 2007–2008 to 2016–2017, in two major London secondary mental healthcare providers

Summary Trends in detention under the Mental Health Act 1983 in two major London secondary mental healthcare providers were explored using patient-level data in a historical cohort study between 2007–2008 and 2016–2017. An increase in the number of detention episodes initiated per fiscal year was observed at both sites. The rise was accompanied by an increase in the number of active patients; the proportion of active patients detained per year remained relatively stable. Findings suggest that the rise in the number of detentions reflects the rise of the number of people receiving secondary mental healthcare.

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The Indonesian Mental Health Act: psychiatrists’ views on the act and its implementation

Health Policy and Planning ◽

10.1093/heapol/czaa139 ◽

2020 ◽

Author(s):

Annemieke P Bikker ◽

Cokorda Bagus Jaya Lesmana ◽

Niko Tiliopoulos

Keyword(s):

Mental Health ◽

Clinical Practice ◽

Local Level ◽

Healthcare Providers ◽

Mental Healthcare ◽

Implementation Process ◽

Structured Interview ◽

Evidence Base ◽

Political Issue ◽

Mental Health Act

Abstract In 2014, the Indonesian government passed the Mental Health Act (MHA) to address the country’s complex mental health situation. The implementation of the MHA has been slow, and little is known about how the MHA is perceived by mental healthcare providers within local settings. This study aimed to obtain insight into psychiatrists’ views on the MHA, including on how it affected their clinical practice and on challenges of translating the MHA into practice. The study was conducted in Bali, and 27 psychiatrists (15 men and 12 women) participated in a semi-structured interview. Thematic analysis indicated four overarching themes: raising the profile of mental health, developing a shared understanding of mental illness, integrating psychiatric practice with other services and views on implementation of the MHA into practice. Overall, the psychiatrists viewed the MHA as a step in the right direction to improve mental health services and to create awareness at local and national levels. However, there was consensus that the meaning of the MHA’s concepts of mental problems and disorders were not compatible with psychiatric everyday practice or their patients’ understandings. As a result, many assumed that the MHA was targeted at government and policy officials. Furthermore, there was a perceived lack of clarity on issues relating to collaborating with other services and unequal access to resources among regencies that impacted on their clinical practice in a negative way. Moreover, a few psychiatrists raised concerns that local beliefs and practices were not acknowledged in the MHA. According to the participants, mental health remained a highly political issue and without national support, mental health would remain a low priority. In conclusion, insights into providers’ perspectives contribute to developing an evidence-base that can inform the implementation process of the MHA in Indonesia, and possibly elsewhere, into local level guidelines and regulations.

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Mental health law in Ghana

BJPsych International ◽

10.1192/s2056474000001768 ◽

2017 ◽

Vol 14 (2) ◽

pp. 38-39 ◽

Cited By ~ 7

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.

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A human right to be detained? Mental healthcare after ‘Savage’ and ‘Rabone'

The Psychiatrist ◽

10.1192/pb.bp.112.040980 ◽

2013 ◽

Vol 37 (9) ◽

pp. 294-296 ◽

Cited By ~ 1

Author(s):

Mohammad Shaiyan Rahman ◽

Nadya Wolferstan

Keyword(s):

Mental Health ◽

Mental Health Service ◽

Service Providers ◽

Healthcare Providers ◽

Mental Healthcare ◽

Case Law ◽

Human Right ◽

Health Service Providers ◽

The Uk ◽

Suicidal Patients

SummaryThe UK courts have recently considered the management of suicidal patients in the cases of Savage and Rabone. As a result of these judgments, the case law has extended significantly the responsibilities of mental healthcare providers. In this article we discuss the repercussions of these landmark decisions which are likely to have significant consequences for mental health service providers in the UK.

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Geographical identification of the vulnerable groups during COVID-19 crisis: the typhoon eye effect and its boundary conditions

10.1101/2020.04.28.20083667 ◽

2020 ◽

Author(s):

Pok Man Tang ◽

Stephen X. Zhang ◽

Chi Hon Li ◽

Feng Wei

Keyword(s):

Mental Health ◽

Life Satisfaction ◽

Boundary Conditions ◽

Healthcare Providers ◽

Negative Relationship ◽

Mental Healthcare ◽

Well Being ◽

Vulnerable Groups ◽

Negative Consequences ◽

Working Adults

AimAlthough some studies suggest the coronavirus disease (COVID-19) is associated with negative consequences on physical health, our knowledge about the detrimental effects of COVID-19 on people’s mental health is still nascent. This study uses typhoon eye theory to offer insights in helping clinical psychiatrists to screen people with well-being issues during COVID-19 outbreak.MethodsWe collected survey data from working adults across different geographical areas in China on 20 and 21 February 2020 during the outbreak of COVID-19. The sample contains 308 working adults, who were in various parts of China, with varying distance to the epicenter of Wuhan.ResultsIndividual adults’ distance to the epicenter was negatively associated with life satisfaction (β = −0.235, 95% CI −0.450 to −0.020, p = 0.032). This association between distance and life satisfaction was significant only for adults who were young or had smaller family sizes. For example, the negative relationship was strongest when the individuals were in the age bracket of 20 years old (15.7%; β = −0.703, 95% CI −1.098 to −0.307; p = 0.001) and single (32.3%; β = −0.767, 95% CI −1.125 to −0.408; p < 0.001).ConclusionOur results that people’s well-being deteriorates by the distance from the epicenter for specific groups of people help guide mental healthcare providers towards the regions that are further away from the epicenter in the ongoing COVID-19 outbreak. Meanwhile, our results indicate the practitioners should be cautious of using typhoon eye effect for individuals who were older or had a larger family size.

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Perinatal mental health around the world: priorities for research and service development in China

BJPsych International ◽

10.1192/bji.2020.5 ◽

2020 ◽

Vol 17 (3) ◽

pp. 50-53 ◽

Cited By ~ 1

Author(s):

Simone Eliane Schwank ◽

Qiongjie Zhou ◽

Yanling He ◽

Ganesh Acharya

Keyword(s):

Mental Health ◽

Mental Disorders ◽

Perceived Risk ◽

Help Seeking ◽

Healthcare Providers ◽

Mental Healthcare ◽

Healthcare Services ◽

Service Development ◽

Community Healthcare ◽

Help Seeking Behaviour

China's healthcare is improving together with rapid economic growth. Yet, mental healthcare is lagging behind. Prevalence of perinatal depression is high among women of the one-child generation, but access to qualified care is limited. Chinese healthcare professionals, policy makers and patients alike express concerns about insufficient knowledge among the public as well as healthcare providers regarding mental disorders. There appears to be a general lack of help-seeking behaviour for mental disorders owing to perceived risk of social stigmatisation. Social support through family and friends, use of online resources and community healthcare services are preferred, rather than seeking help from mental health specialists.

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Emergency workers’ experiences of the use of section 136 of the Mental Health Act 1983: interpretative phenomenological investigation

BJPsych Bulletin ◽

10.1192/bjb.2020.21 ◽

2020 ◽

Vol 44 (6) ◽

pp. 250-254 ◽

Cited By ~ 1

Author(s):

Mirella Genziani ◽

Steve Gillard ◽

Lana Samuels ◽

Mary Chambers

Keyword(s):

Mental Health ◽

Police Officers ◽

Interpretative Phenomenological Analysis ◽

Mental Healthcare ◽

Healthcare Services ◽

Negative Experiences ◽

Mental Health Act ◽

Police Data ◽

Emergency Workers ◽

The Individual

Aims and methodTo explore the experiences of emergency workers dealing with incidents in which section 136 of the Mental Health Act 1983 is invoked by the police. Data from interviews with police officers and ambulance workers in a London locality were subject to interpretative phenomenological analysis.ResultsParticipants felt they were the first port of call and that training should be improved to help them deal with those experiencing mental health crises in the community. Police participants noted time pressures trying to gain individuals’ trust and described section 136 detention as sometimes feeling like a betrayal of the individual. Most participants had negative experiences of admissions to the 136 suite; several suggested ways of improving the admissions system. Several went beyond their expected duties to ensure that distressed individuals were supported before accessing mental healthcare services.Clinical implicationsImproving training of emergency workers in dealing with mental health crises would also help with aftercare decision-making. Learning identified from the participants’ experiences lends support to collaboration between emergency and mental health services, an important step towards improving the section 136 process so that detainees can access help without unnecessary delay.

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Community treatment orders and associations with readmission rates and duration of psychiatric hospital admission: a controlled electronic case register study

BMJ Open ◽

10.1136/bmjopen-2019-035121 ◽

2020 ◽

Vol 10 (3) ◽

pp. e035121 ◽

Cited By ~ 4

Author(s):

Wikus Barkhuizen ◽

Alexis E Cullen ◽

Hitesh Shetty ◽

Megan Pritchard ◽

Robert Stewart ◽

...

Keyword(s):

Mental Health ◽

Mortality Rate ◽

Psychiatric Hospital ◽

Mental Healthcare ◽

Index Admission ◽

Community Treatment ◽

Lower Mortality ◽

Community Treatment Orders ◽

Electronic Health Record Data ◽

Mental Health Act

ObjectivesLimited evidence is available regarding the effect of community treatment orders (CTOs) on mortality and readmission to psychiatric hospital. We compared clinical outcomes between patients placed on CTOs to a control group of patients discharged to voluntary community mental healthcare.Design and settingAn observational study using deidentified electronic health record data from inpatients receiving mental healthcare in South London using the Clinical Record Interactive Search (CRIS) system. Data from patients discharged between November 2008 and May 2014 from compulsory inpatient treatment under the Mental Health Act were analysed.Participants830 participants discharged on a CTO (mean age 40 years; 63% male) and 3659 control participants discharged without a CTO (mean age 42 years; 53% male).Outcome measuresThe number of days spent in the community until readmission, the number of days spent in inpatient care in the 2 years prior to and the 2 years following the index admission and mortality.ResultsThe mean duration of a CTO was 3.2 years. Patients receiving care from forensic psychiatry services were five times more likely and patients receiving a long-acting injectable antipsychotic were twice as likely to be placed on a CTO. There was a significant association between CTO receipt and readmission in adjusted models (HR: 1.60, 95% CI 1.42 to 1.80, p<0.001). Compared with controls, patients on a CTO spent 17.3 additional days (95% CI 4.0 to 30.6, p=0.011) in a psychiatric hospital in the 2 years following index admission and had a lower mortality rate (HR: 0.66, 95% CI 0.50 to 0.88, p=0.004).ConclusionsMany patients spent longer on CTOs than initially anticipated by policymakers. Those on CTOs are readmitted sooner, spend more time in hospital and have a lower mortality rate. These findings merit consideration in future amendments to the UK Mental Health Act.

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Agreement between patients and mental healthcare providers on unmet care needs in child and adolescent psychiatry

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-020-01969-8 ◽

2020 ◽

Author(s):

Richard Vijverberg ◽

Robert Ferdinand ◽

Aartjan Beekman ◽

Berno van Meijel

Keyword(s):

Mental Health ◽

Unmet Needs ◽

Mental Health Problems ◽

Healthcare Providers ◽

Unmet Need ◽

Young Patients ◽

Mental Healthcare ◽

Child And Adolescent Psychiatry ◽

Care Providers ◽

Care Needs

Abstract Purpose In mental health care, patients and their care providers may conceptualize the nature of the disorder and appropriate action in profoundly different ways. This may lead to dropout and lack of compliance with the treatments being provided, in particular in young patients with more severe disorders. This study provides detailed information about patient–provider (dis)agreement regarding the care needs of children and adolescents. Methods We used the Camberwell Assessment of Need (CANSAS) to assess the met and unmet needs of 244 patients aged between 6 and 18 years. These needs were assessed from the perspectives of both patients and their care providers. Our primary outcome measure was agreement between the patient and care provider on unmet need. By comparing a general outpatient sample (n = 123) with a youth-ACT sample (n = 121), we were able to assess the influence of severity of psychiatric and psychosocial problems on the extent of agreement on patient’s unmet care needs. Results In general, patients reported unmet care needs less often than care providers did. Patients and care providers had the lowest extents of agreement on unmet needs with regard to “mental health problems” (k = 0.113) and “information regarding diagnosis/treatment” (k = 0.171). Comparison of the two mental healthcare settings highlighted differences for three-quarters of the unmet care needs that were examined. Agreement was lower in the youth-ACT setting. Conclusions Clarification of different views on patients’ unmet needs may help reduce nonattendance of appointments, noncompliance, or dropout. Routine assessment of patients’ and care providers’ perceptions of patients’ unmet care needs may also help provide information on areas of disagreement.

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Parenting and personality disorder: clinical and child protection implications

BJPsych Advances ◽

10.1192/apt.bp.113.011627 ◽

2015 ◽

Vol 21 (1) ◽

pp. 15-22 ◽

Cited By ~ 7

Author(s):

Gwen Adshead

Keyword(s):

Mental Health ◽

Personality Disorder ◽

Child Development ◽

Personality Disorders ◽

Child Protection ◽

Psychiatric Morbidity ◽

Healthcare Providers ◽

Mental Healthcare ◽

Parental Mental Health ◽

Psychological Burden

SummaryI review some of the evidence that parental personality disorder represents a risk to child development, in terms of both transmission of genetic vulnerability and the environmental stress of living with a parent who has a personality disorder that negatively affects their parenting capacities. I argue that there are two compelling reasons to impose a duty on mental healthcare providers to offer services for adults with personality disorders that specifically focus on their parenting identity: first, because effective therapies for personality disorder are now available; and second, because there is a strong utilitarian and economic argument for improving parental mental health so as to reduce the economic and psychological burden of their offsprings' future psychiatric morbidity.

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Managing outcome performance in mental health using HoNOS: experience at St Andrew's Healthcare

Psychiatric Bulletin ◽

10.1192/pb.bp.108.022475 ◽

2009 ◽

Vol 33 (8) ◽

pp. 285-288 ◽

Cited By ~ 16

Author(s):

Philip Sugarman ◽

Lorraine Walker ◽

Geoff Dickens

Keyword(s):

Mental Health ◽

Healthcare Providers ◽

Mental Healthcare ◽

Clinical Effectiveness ◽

Service Level ◽

Outcome Data ◽

Validity Of Results ◽

Health Records ◽

Key Stakeholders ◽

Outcome Performance

Aims and MethodModern mental healthcare providers must demonstrate service-level clinical effectiveness to key stakeholders. We introduced two performance indicators of clinical effectiveness based on outcome data from routinely collected Health of the Nation Outcome Scales (HoNOS) and HoNOS–secure assessments across St Andrew's Healthcare, a charity providing in-patient services in Northampton and Essex. We present outcome data from the period 2004–2007.ResultsThe indicators showed consistent 90-day improvement rates and increasing stability over time. the validity of results is supported by levels of change along predicted lines among different patient cohorts.Clinical ImplicationsIt is possible and beneficial to use routine outcome measures to demonstrate clinical effectiveness at service level. the future of managing mental health outcomes will be in electronic health records systems.

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