scholarly journals Does compulsory or supervised community treatment reduce ‘revolving door’ care?

2007 ◽  
Vol 191 (5) ◽  
pp. 373-374 ◽  
Author(s):  
Stephen Kisely ◽  
Leslie Anne Campbell
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Epidemiological Studies ◽  
Previous Literature ◽  
Revolving Door ◽  
Community Treatment ◽  
England And Wales ◽  
Mental Health Act

SummarySupervised community treatment to address ‘revolving door’ care is part of the new Mental Health Act in England and Wales. Two recent epidemiological studies in Australia (n > 118 000), as well as a systematic review of all previous literature using appropriately matched or randomised controls (n = 1108), suggest that it is unlikely to help.

scholarly journals Community Treatment Orders

2014 ◽  
Vol 1 (16) ◽  
pp. 149
Author(s):  
Kris Gledhill
Keyword(s):  
Mental Health ◽  
Revolving Door ◽  
Community Treatment ◽  
Patient Treatment ◽  
England And Wales ◽  
Mental Health Act ◽  
Heated Debate ◽  
Policy Objectives ◽  
Treatment Order ◽  
Community Treatment Order

<p>A community treatment order is now a well-established feature of various common law jurisdictions in North America and Australasia, and in other countries. Its introduction into England and Wales was a central part of the government’s drawn out reform of the Mental Health Act 1983, and it attracted heated debate as part of the Parliamentary process, both in the exchanges between Parliamentarians and the evidence and briefings filed by interested parties. A CTO provision was introduced with a speedier gestation period in Scotland. But there is no single form of “community treatment order”; and there may also be different policy objectives. What is usually central is the desire to provide a regime for patients who are assessed as being able to function in the community so long as they accept medication but who may disengage from treatment and relapse to the extent that they require in-patient treatment: the description “revolving door” is often attached to such patients and was during the course of the debates.</p><p>The first question to be explored is whether what emerged in the Mental Health Act 2007 is much different from what already exists in relation to such patients: if it is and it allows community treatment which was previously not available, the further question is whether that is a good thing in light of the experience of other jurisdictions that have CTO regimes. If it is not, there are two further questions: firstly, why has something called a CTO been introduced if it does not amount to a change of substance; and secondly, is it a missed opportunity in light of the information from other jurisdictions – in other words, would a substantive change provide benefits which England and Wales is now missing?</p>

scholarly journals Compulsion in the community? The introduction of supervised community treatment

2010 ◽  
Vol 16 (4) ◽  
pp. 245-252 ◽  
Author(s):  
Guy Brookes ◽  
Nick Brindle
Keyword(s):  
Mental Health ◽  
Health Professionals ◽  
Community Treatment ◽  
Mental Health Practitioners ◽  
England And Wales ◽  
Mental Health Act ◽  
Health Practitioners ◽  
Legislative Framework

SummarySupervised community treatment (SCT) is one of the most prominent amendments to the Mental Health Act 1983. It has divided opinion among health professionals and introduces significant powers not previously available in England and Wales. This article considers how SCT fits into the established legislative framework and how it may affect the care delivered by mental health practitioners.

Supervised community treatment: guidance for clinicians

2010 ◽  
Vol 16 (4) ◽  
pp. 253-259 ◽  
Author(s):  
Rob Macpherson ◽  
Andrew Molodynski ◽  
Rachel Freeth ◽  
Amjad Uppal ◽  
Hannah Steer ◽  
...  
Keyword(s):  
Mental Health ◽  
Evidence Base ◽  
Community Treatment ◽  
England And Wales ◽  
Mental Health Act ◽  
Local Experience ◽  
The Uk

SummaryThis article describes the background to the introduction of supervised community treatment (SCT) in the 2007 amendments to the Mental Health Act 1983 for England and Wales. The evidence base for the use of SCT in the UK and in other countries to date is considered, and guidance from the literature regarding the decision to impose it is reviewed. Early local experience of SCT is described, in part through a number of fictitious vignettes. Finally, we present a set of guidelines which may be used by clinicians when considering SCT.

scholarly journals Towards an Understanding of Supervised Community Treatment

2014 ◽  
Vol 1 (17) ◽  
pp. 7
Author(s):  
Mat Kinton
Keyword(s):  
Mental Health ◽  
The Other ◽  
Community Treatment ◽  
Community Treatment Orders ◽  
England And Wales ◽  
Mental Health Act ◽  
Relationship Of ◽  
The Relationship

<p>I intend here to look at two related areas: first, the actual powers that supervised community treatment provides to clinicians, especially in relation to the administration of treatment, and, second, the relationship of SCT with the other community powers of the Mental Health Act, especially the power under s.17 to allow detained patients leave from hospital. Whether such a focus will enable us to be “sure of the thing” that is SCT is perhaps doubtful, and we obviously cannot resolve the question of how (or indeed if) the SCT regime will be operated in practice across England and Wales, but it may help us to think more clearly about the possibilities and prepare ourselves to untangle some of the knots established in the primary legislation. I will conclude with some comments on the potential numbers of patients involved and whether Scotland’s experience of community treatment orders tells us anything about the likely implementation of powers in England and Wales.</p>

A Systematic Review of Research Relating to the Mental Health Act (1983)

1998 ◽  
Author(s):  
Rachel Churchill ◽  
Sharon Wall ◽  
Matthew Hotopf ◽  
Alec Buchanan ◽  
Simon Wessely
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Mental Health Act

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.

R v Westwood (Thomas): diminished responsibility and disposals under the Mental Health Act 1983

2021 ◽  
Vol 72 (2) ◽  
Author(s):  
Sean Mennim
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
England And Wales ◽  
Mental Health Act ◽  
Court Of Appeal ◽  
Diminished Responsibility

This is a commentary on R v Westwood (Thomas), where the Court of Appeal of England and Wales held that the judge had erred in assessing Westwood’s ‘retained responsibility’ as medium to high under the Sentencing Council Guideline for manslaughter by reason of diminished responsibility. Although the sentencing judge concluded that the offending was caused by Westwood’s anger, the Court of Appeal found the psychiatric evidence clearly indicated that the most significant factor was Westwood’s mental illness and that his anger at the time of the offence was a manifestation of his mental illness. Westwood’s responsibility was low, and it was appropriate to impose both a hospital and restriction order.  

7. Mental Health Law

Medical Law ◽  
2019 ◽  
pp. 351-419
Author(s):  
Emily Jackson
Keyword(s):  
Mental Health ◽  
Community Treatment ◽  
Health Law ◽  
Persons With Disabilities ◽  
Mental Health Law ◽  
Mental Health Act ◽  
Independent Review ◽  
History Of ◽  
Human Rights Act ◽  
The Uk

All books in this flagship series contain carefully selected substantial extracts from key cases, legislation, and academic debate, providing able students with a stand-alone resource. This chapter discusses mental health law in the UK. It begins with a brief history of mental health law and policy. This is followed by discussions of: admission to the mental health system; treatment of the mentally ill under the Mental Health Act 1983; Deprivation of Liberty Safeguards (DoLS) and Cheshire West, and Community Treatment Orders. It also looks at the implications of the Human Rights Act and the UN Convention on the Rights of Persons with Disabilities (UNCRPD) for mental health law. It also considers the conclusions of the Independent Review of the Mental Health Act 1983.

scholarly journals Repeated Police Mental Health Act Detentions in England and Wales: Trauma and Recurrent Suicidality

2019 ◽  
Vol 16 (23) ◽  
pp. 4786
Author(s):  
Claire Warrington
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Mental Health Problems ◽  
Police Intervention ◽  
England And Wales ◽  
Mental Health Act ◽  
Self Harm ◽  
South East England ◽  
National Police

Most police Mental Health Act (Section 136) detentions in England and Wales relate to suicide prevention. Despite attempts to reduce detention rates, numbers have risen almost continually. Although Section 136 has been subject to much academic and public policy scrutiny, the topic of individuals being detained on multiple occasions remains under-researched and thus poorly understood. A mixed methods study combined six in-depth interviews with people who had experienced numerous suicidal crises and police intervention, with detailed police and mental health records. A national police survey provided wider context. Consultants with lived experience of complex mental health problems jointly analysed interviews. Repeated detention is a nationally recognised issue. In South East England, it almost exclusively relates to suicide or self-harm and accounts for a third of all detentions. Females are detained with the highest frequencies. The qualitative accounts revealed complex histories of unresolved trauma that had catastrophically damaged interviewee’s relational foundations, rendering them disenfranchised from services and consigned to relying on police intervention in repeated suicidal crises. A model is proposed that offers a way to conceptualise the phenomenon of repeated detention, highlighting that long-term solutions to sustain change are imperative, as reactive-only responses can perpetuate crisis cycles.

Do we need community treatment orders in Ireland?

2010 ◽  
Vol 27 (2) ◽  
pp. 90-96 ◽  
Author(s):  
Dermot Walsh
Keyword(s):  
Criminal Law ◽  
Convincing Evidence ◽  
Revolving Door ◽  
Community Treatment ◽  
Community Treatment Orders ◽  
England And Wales ◽  
Inpatient Psychiatric Care ◽  
Early Introduction ◽  
Compulsory Community Treatment ◽  
Conditional Discharge

AbstractObjectives: Re-admissions to inpatient psychiatric care are now so frequent as to be designated the ‘revolving door’ phenomenon and constitute 72% of admissions to Irish inpatient psychiatric units and hospitals. It is commonly believed that treatment non-adherence with aftercare following inpatient discharge contributes to readmission. Attempts to improve adherence and reduce or shorten readmission through compulsory community treatment orders have been made in several countries including Scotland in 2005 and, from November 2008, England and Wales. Provision for conditional discharge in Ireland has already been furnished by the Criminal Law (Insanity) Act 2006 but has been compromised by the inability to impose enforcement of conditions. The paper aims to determine whether compulsory community treatment orders are effective in improving adherence and reducing re-admission and whether, in consequence, their introduction in Ireland should be considered.Method: The legislative measures adopted to improve treatment adherence and thereby reduce re-admissions are presented. The evidence of their effectiveness is examined.Results: Evaluation of the effectiveness of community treatment orders is limited and hindered by confounding factors. What evidence there is does not provide convincing evidence of their utility.Conclusions: It is concluded that there is insufficient evidence to advocate their early introduction in Ireland in civil mental health legislation. Instead a wait and see policy is suggested with critical assessment of the outcome of such developments in Scotland and England and Wales. In addition further research on the characteristics of revolving door patients in Ireland and the circumstances determining their readmission is advocated. There is an anomaly in the Criminal Law (Insanity) Act 2006 which allows of conditional discharge but does not provide for its enforcement.

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