scholarly journals Information, consent and perceived coercion: patients' perspectives on electroconvulsive therapy

2005 ◽  
Vol 186 (1) ◽  
pp. 54-59 ◽  
Author(s):  
Dana S. Rose ◽  
Til H. Wykes ◽  
Jonathan P. Bindman ◽  
Pete S. Fleischmann
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Informed Consent ◽  
Electroconvulsive Therapy ◽  
Common Law ◽  
Sufficient Information ◽  
Compulsory Treatment ◽  
Perceived Coercion ◽  
Mental Health Legislation ◽  
Health Legislation

BackgroundElectroconvulsive therapy (ECT) is a procedure that attracts special safeguards under common law for voluntary patients and under both current and proposed mental health legislation, for those receiving compulsory treatment.AimsTo review patients' views on issues of information, consent and perceived coercion.MethodSeventeen papers and reports were identified that dealt with patients' views on information and consent in relation to ECT; 134 ‘testimonies' or first-hand accounts were identified. The papers and reports were subjected to a descriptive systematic review. The testimony data were analysed qualitatively.ResultsApproximately half the patients reported that they had received sufficient information about ECT and side-effects. Approximately a third did not feel they had freely consented to ECTeven when they had signed a consent form. Clinician-led research evaluates these findings to mean that patients trust their doctors, whereas user-led work evaluates similar findings as showing inadequacies in informed consent.ConclusionNeither current nor proposed safeguards for patients are sufficient to ensure informed consent with respect to ECT, at least in England and Wales.

scholarly journals Compulsory admission and involuntary treatment in Portugal

2016 ◽  
Vol 13 (1) ◽  
pp. 17-19 ◽  
Author(s):  
Telma Almeida ◽  
Andrew Molodynski
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Patient Treatment ◽  
Compulsory Treatment ◽  
Compulsory Admission ◽  
Involuntary Treatment ◽  
Mental Health Legislation ◽  
Health Legislation

This paper details the grounds for compulsory treatment, compulsory admissions in an emergency department and compulsory out-patient treatment in Portugal. Portuguese mental health legislation has improved significantly over recent years, with enhanced safeguards, rapid and rigorous review and clear criteria for compulsory treatment, although much remains to be done, especially in relation to the ‘move into the community’.

scholarly journals Involuntary community treatment in New South Wales, Australia

1995 ◽  
Vol 19 (1) ◽  
pp. 45-47 ◽  
Author(s):  
John Hambridge ◽  
Nicola Watt
Keyword(s):  
Mental Health ◽  
Mentally Ill ◽  
New South ◽  
New South Wales ◽  
Community Treatment ◽  
Compulsory Treatment ◽  
Perceived Benefits ◽  
South Wales ◽  
Mental Health Legislation ◽  
Health Legislation

The New South Wales Mental Health Act (1990) heralded a number of important changes to mental health legislation in the state. One of these was the option to give compulsory treatment to mentally ill clients living in the community. This article briefly explains community treatment under the Act, and the perceived benefits and the limitations of such legislation. A case example is used to illustrate some of these points. Involuntary community treatment is seen as a less restrictive alternative to hospitalisation for a number of mentally ill clients, but the use of such provisions demands significant resources from the supervising agency.

scholarly journals Compulsory treatment in the community: current legal powers

2002 ◽  
Vol 8 (3) ◽  
pp. 180-188 ◽  
Author(s):  
Steffan Davies
Keyword(s):  
Mental Health ◽  
Northern Ireland ◽  
Compulsory Treatment ◽  
England And Wales ◽  
Mental Health Act ◽  
Department Of Health ◽  
Mental Health Legislation ◽  
Health Legislation

Reform of mental health legislation has been under consideration for several years in England and Wales (Department of Health, 2000a), where the Mental Health Act 1983 is in force, and in Scotland (Millan Committee Secretariat, 2001), which is governed by the Mental Health (Scotland) Act 1984. The Mental Health (Northern Ireland) Order 1986 is also under review, although the findings have yet to be published.

scholarly journals Service users’ perspective of their admission: a report of study findings

2016 ◽  
Vol 34 (4) ◽  
pp. 251-260 ◽  
Author(s):  
B. O’Donoghue ◽  
E. Roche ◽  
J. Lyne ◽  
K. Madigan ◽  
L. Feeney
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Procedural Justice ◽  
Community Mental Health Services ◽  
Service Users ◽  
Perceived Coercion ◽  
Mental Health Legislation ◽  
Health Legislation ◽  
Satisfaction With Services

ObjectivesThe ‘Service Users’ Perspective of their Admission’ study examined voluntarily and involuntarily admitted services users’ perception of coercion during the admission process and whether this was associated with factors such as the therapeutic alliance, satisfaction with services, functioning and quality of life. This report aims to collate the findings of the study.MethodsThe study was undertaken across three community mental health services in Ireland. Participants were interviewed before discharge and at 1 year using the MacArthur Admission Experience. Caregivers of participants were interviewed about their perception of coercion during the admission.ResultsA total of 161 service users were interviewed and of those admitted involuntarily, 42% experienced at least one form of physical coercion. Service users admitted involuntarily reported higher levels of perceived coercion and less procedural justice than those admitted voluntarily. A total of 22% of voluntarily admitted service users reported levels of perceived coercion comparable with involuntarily admitted service users and this was associated with treatment in a secure ward or being brought to hospital initially under mental health legislation. In comparison with the service user, caregivers tended to underestimate the level of perceived coercion. The level of procedural justice was moderately associated with the therapeutic relationship and satisfaction with services. After 1 year, 70% experienced an improvement in functioning and this was not associated with the accumulated level of coercive events, when controlled for confounders.ConclusionsThis study has provided valuable insights into the perceptions of coercion and can help inform future interventional studies aimed at reducing coercion in mental health services.

scholarly journals Mental health law in New Zealand

2016 ◽  
Vol 13 (2) ◽  
pp. 43-45 ◽  
Author(s):  
Ian Soosay ◽  
Rob Kydd
Keyword(s):  
Mental Health ◽  
New Zealand ◽  
Modern State ◽  
Compulsory Treatment ◽  
Health Law ◽  
Mental Health Legislation ◽  
Assessment And Treatment ◽  
History Of ◽  
Constitutional Protections ◽  
Health Legislation

New Zealand has an established history of mental health legislation that sits within a framework of human rights, disability and constitutional protections. We outline a brief history of mental health legislation in New Zealand since its inception as a modern state in 1840. The current legislation, the Mental Health (Compulsory Assessment and Treatment) Act 1992, defines mental disorder and the threshold for compulsory treatment. We describe its use in clinical practice and the wider legal and constitutional context which psychiatrists need to be aware of in their relationships with patients.

The views and outcomes of consenting and non-consenting patients receiving ECT

1999 ◽  
Vol 29 (1) ◽  
pp. 221-223 ◽  
Author(s):  
T. J. WHEELDON ◽  
C. ROBERTSON ◽  
J. M. EAGLES ◽  
I. C. REID
Keyword(s):  
Mental Health ◽  
Informed Consent ◽  
Clinical Outcome ◽  
Medical Evaluation ◽  
Independent Medical Evaluation ◽  
Mental Health Legislation ◽  
Seriously Ill Patients ◽  
The Uk ◽  
Health Legislation ◽  
Seriously Ill

Background. Current mental health legislation in the UK makes provision for the use of certain treatments in severely ill patients who are unable, or unwilling, to give informed consent. Under the terms of this legislation, electroconvulsive therapy (ECT) may be used, usually to treat severely depressed patients. A number of organizations have challenged this practice, stating that ECT should only be given with fully informed consent: it has been implied that patients receiving compulsory ECT (given without the patient's consent, under the terms of mental health legislation) find the treatment damaging and unhelpful.Methods. A series of 150 patients receiving ECT in Aberdeen was studied. A proportion of the series (approximately 7%) received compulsory ECT. The views and treatment outcomes of compulsory patients were compared with those of patients giving informed consent for treatment.Results. More than 80% of patients in both consenting and compulsory groups considered ECT to have helped them. Clinical outcome did not differ between the groups. Patients' views showed marked concordance with independent medical evaluation of outcome.Conclusions. Outcome following ECT in non-consenting patients is equivalent to that seen in consenting patients whether rated by the patients themselves or by clinicians. Overall outcome is good, with more than 80% of patients benefiting from treatment. A ban on compulsory ECT would deny the access of seriously ill patients to an effective and acceptable treatment.

Consent and Treatment

1992 ◽  
Vol 26 (3) ◽  
pp. 516-517
Author(s):  
Graham Ridley
Keyword(s):  
Mental Health ◽  
Informed Consent ◽  
Mental Health Legislation ◽  
Consent To Treatment ◽  
Health Legislation

I found Dr Wallace's letter (Journal, 1992, 26:330-33 1) most interesting. I am familiar with mental health legislation in both the English and Victorian systems, and both of these — in common, I suspect with many other such systems — have the similar problems of being unable to cater for voluntary patients willing to be in hospital but unable to give informed consent to treatment.

scholarly journals New mental health legislation in Scotland

2008 ◽  
Vol 14 (2) ◽  
pp. 89-97 ◽  
Author(s):  
Donald Lyons
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Early Data ◽  
Monitoring Data ◽  
Compulsory Treatment ◽  
Mental Health Legislation ◽  
Care And Treatment ◽  
Health Legislation

The Mental Health (Care and Treatment) (Scotland) Act 2003 was implemented in October 2005. This article summarises the main features of the Act and its differences from previous legislation. The Act was intended to provide a more flexible range of interventions, including compulsory treatment in the community. It also introduced a number of new safeguards. These are described and early data on their impact are presented. Some provisions of the Act are time-consuming and cumbersome, but there is evidence that psychiatrists are committed to its principles and this is borne out by early monitoring data. Some aspects of the Act are being reviewed at the time of writing.

scholarly journals Canada's mental health legislation

2014 ◽  
Vol 11 (3) ◽  
pp. 65-67
Author(s):  
Richard L. O'Reilly ◽  
John E. Gray
Keyword(s):  
Mental Health ◽  
Common Law ◽  
Civil Code ◽  
Community Treatment ◽  
Involuntary Admission ◽  
Mental Health Legislation ◽  
Clinically Significant ◽  
Health Legislation ◽  
Health Laws

In Canada the ten provinces and three territories are responsible for their own health laws and services. The 13 mental health acts have core similarities, but there are clinically significant differences. In most Canadian jurisdictions legislation is based on common law; in Quebec, it is based on a civil code. Canadian jurisdictions favour voluntary admission and sometimes make this explicit in their mental health acts. For involuntary admission or compulsory in-patient or community treatment to be valid, three elements must be applied correctly: the process, the criteria and the rights procedures. These are reviewed in this paper.

Sign in / Sign up

Export Citation Format

Share Document