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.

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.

Attitudes and experiences of nursing staff to the Mental Health Act 2001: lessons for future mental health legislation

2014 ◽  
Vol 31 (2) ◽  
pp. 83-87 ◽  
Author(s):  
A. M. Doherty ◽  
F. Jabbar ◽  
B. D. Kelly
Keyword(s):  
Mental Health ◽  
Nursing Staff ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mental Health Act ◽  
Clinical Nursing ◽  
Mental Health Legislation ◽  
Paper Work ◽  
Health Legislation ◽  
The Impact

ObjectivesThe Mental Health Act 2001 was implemented in 2006 to bring Ireland into line with international practice and United Nations Conventions on Human Rights. Previous studies have reported some practical difficulties for the professionals involved. We wished to examine the experiences of nursing staff and the impact of the Act on clinical nursing practice since its implementation.MethodThis cross-sectional survey was conducted by questionnaire. It contained questions examining training in and attitudes to the Act, and any resultant changes in nursing practise.ResultsA total of 317 questionnaires were returned. Of the nurses, 92% reported having received training in the Act, and 56% of nursing staff believed that their workload had increased as a result of the change in legislation. Of those who made a comment, 76.5% were negative, with increased paper work, lack of clarity and an excessive focus on legalities being the most common difficulties reported.ConclusionsNursing staff have shown mixed attitudes to the Mental Health Act 2001, but many of the difficulties encountered are similar to those experienced by other professionals.

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 1. Rainford Ward, Rainhill Hospital, Merseyside

1979 ◽  
Vol 3 (3) ◽  
pp. 43-44
Author(s):  
J. Higgins
Keyword(s):  
Nursing Staff ◽  
The Other ◽  
Staffing Levels ◽  
Mental Hospitals ◽  
Secure Unit

Following discussions with representatives of medical and nursing staff in September 1974, it was decided that each of the four mental hospitals of the Merseyside Region should make interim arrangements pending the construction of a purpose-built Regional Secure Unit. Three hospitals decided to open an Interim Secure Unit, the other to accept the monies offered to increase staffing levels on admission wards.

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.

Attitudes and experiences to the implementation of the Mental Health Act 2001

2011 ◽  
Vol 26 (S2) ◽  
pp. 755-755 ◽  
Author(s):  
A.M. Doherty ◽  
F. Jabbar ◽  
B.D. Kelly
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Nursing Staff ◽  
Nursing Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mental Health Act ◽  
Chain Of Command ◽  
Paper Work ◽  
The Impact

IntroductionThe Mental Health Act 2001 was implemented in November 2006 and its introduction has heralded many important changes in the provision of mental health care in Ireland.ObjectivesTo examine the impact of the Act on the time and patterns of attention given to patients since its implementation, and to look at some of the difficulties encountered.AimsTo propose amendments to the legislation, based on the experiences elicited.MethodsThis cross-sectional survey was conducted by questionnaire which we distributed along the chain of command in nursing management. They contained questions looking at attitudes to the Act and the resultant changes in nursing practise. The questionnaire also examined the levels of training with regard to the Act received by members of nursing staff. There was a space given for comments not encompassed by the questions.Results317 questionnaires were returned. 56% of nursing staff believed that their workload had increased as a result of the change in legislation. Of those who made a comment, 76.5% were negative in relation to the new legislation, with increased paper work, lack of clarity and an excessive focus on legal technicalities being the most common difficulties reported.ConclusionNursing staff have shown mixed attitudes to the Mental Health Act 2001. However, as a majority have reported a need for increased training, this is an important need which needs to be met.

scholarly journals Old age liaison psychiatry: audit assessing adherence to referral pathway and referral characteristics including indications, interventions and outcomes

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S112-S113
Author(s):  
Alfred Wong ◽  
Kimberley Boyle
Keyword(s):  
Mental Health ◽  
Psychotropic Medication ◽  
Early Recognition ◽  
Mental Health Disorder ◽  
Referral Process ◽  
Ward Staff ◽  
Early Management ◽  
Mental Health Act ◽  
North East ◽  
Percentage Difference

AimsThis audit covered 3 hospitals in Glasgow City which has 1221 beds providing inpatient healthcare for the north east region of the city. To improve the referral process,we aimed to verify adherence to existing referral pathway and adequacy of information provided by referrals. Referral characteristics including referral indication, intervention and outcomes were accounted for to identify area interest that may help improve the referral process.MethodOur referral pathway involves completion of a Microsoft Word referral template subsequently sent electronically to an internal electronic mail.Referrals in a 2 month period were included in the audit. Each referral was reviewed for adherence to the referral template, adequacy of provided information and referral indications. Intervention in the form of staff input, Mental Health Act status, psychotropic medication prescribed and given diagnosis was ascertained via staff electronic entry records.Result139 referrals were included. 114 referrals (82%) adhered to the referral template. 72 referrals (52%) contained adequate information. Common referral indications were delirium (23%), agitation (20%), low mood (18%) and cognitive decline queries (18%). Staff input ranged from psychiatrist input (46%), liaison nurses (40%), clinical psychology (1%) and shared input (13%). 16 referrals (12%) resulted in subsequent detention under the Mental Health Act. Psychotropic medications prior to liaison assessment included antidepressants (49%), antipsychotics (29%) and benzodiazepines (16%). Liaison assessment resulted in increase use of antipsychotic (55%) and reduction of antidepressants (29%) and benzodiazepines (10%), Delirium (34%), dementia (21%), Mood & Anxiety related disorders (18%) and Query of Cognitive Impairment (14%) were recorded as the most discussed diagnosis.ConclusionReferrals with inadequate details affect the service's ability to efficiently assess for clinical urgency and matching of appropriate interventions to suit clinical needs. The percentage difference in delirium between referral indication and diagnosis highlights that delirium can be under-recognised, resulting in potentially delayed treatment. Identifying common given diagnosis and differences in psychotropic medication prescribing pattern points to the need for training and support of acute medical ward staff in utilising therapeutics for management of acute mental health disorder.A pending electronic referral pathway with mandatory entries and linked relevant online resources can encourage early recognition of acute mental health disorder and prompt early management including the use of appropriate therapeutics. An additional feature allowing direct referrals by acute ward staff to community mental health team would support continuity of care for discharged patients needing ongoing mental health assessment.

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.

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