scholarly journals Haematological monitoring for clozapine: do patients know why?

1995 ◽  
Vol 19 (9) ◽  
pp. 536-537 ◽  
Author(s):  
Carol Paton ◽  
Paul Wolfson
Keyword(s):  
Mental Health ◽  
Side Effects ◽  
Small Proportion ◽  
Second Opinion ◽  
Treatment Resistant ◽  
Blood Tests ◽  
Mental Health Act ◽  
Education Of Patients ◽  
Consent To Treatment

Clozapine is effective in treatment resistant schizophrenia, but unfortunately is associated with a 3% incidence of neutropenia. Regular haematological monitoring is mandatory for all patients. We asked forty patients who had been taking clozapine for more than six months why they thought they had to have regular blood tests. Almost half did not know and only a small proportion were subject to a Mental Health Act (MHA) second opinion for consent to treatment. Initial explanations of the potentially serious side effects of clozapine may not be understood or retained. Ongoing education of patients is essential. The wider use of MHA second opinion doctors should also be considered.

Consent to Treatment, Second Opinion Appointed Doctors and Code Compliance - an Audit?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Qureshi ◽  
G. Kirk
Keyword(s):  
Mental Health ◽  
Treatment Plan ◽  
Medical Officer ◽  
Second Opinion ◽  
Care Plan ◽  
Code Of Practice ◽  
Mental Health Act ◽  
Legal Perspective ◽  
Wide Range ◽  
Consent To Treatment

Aim:Ensuring standards of section 58 documentation and associated communication complies with the code of practice of the Mental Health Act 1983 UK.Method:Case note review of detained patients under section 3 of Mental Health Act (MHA) 1983, requiring either a certificate of consent to treatment (form 38) or a certificate of second opinion authorising treatment (form 39), beyond first three months of medication. A standard checklist was devised, based on recommendations of MHA commission and code of practice.Results:Form 38 (5 Patients), 100% completion of names, dosage, route of adminstration of medication and proposed number of ECT treatments. Only 60% completion of documentation regarding treatment plan explanation and stating whether clozapine was included excluded.Form 39 (7 patients) completed correctly in 100% cases with recommendation by second opinion appointed doctor (SOAD) in 85% cases. No documentation by SOAD in case notes and contact with the responsible medical officer (RMO) was only by phone (should have face to face contact). Only in 28% of cases RMO documented the SOAD visit and outcome.Conclusion:This audit has highlighted wide range of implications from the medico-legal perspective. The statutory documents, form 38 and 39, were completed correctly in majority of cases except for minor omissions. Adequate documentation was lacking with regards to discussion about the care plan and outcome of the SOAD visit. SOAD contact with the RMO was only on the phone (should only be in emergency) and no documentation of the second opinion in the case notes apart from filling the form 39.

scholarly journals Misunderstandings on Consent to Treatment in the Mental Health Act 1983

1984 ◽  
Vol 8 (7) ◽  
pp. 136-137
Author(s):  
P. M. Jefferys
Keyword(s):  
Mental Health ◽  
Second Opinion ◽  
Mental Health Act ◽  
Consent To Treatment

Part IV of the 1983 Mental Health Act (Sections 56–64) introduces new safeguards and procedures relating to Consent to Treatment for detained patients and in limited situations to informal patients. Many psychiatrists have expressed misgivings about these provisions and many are unfamiliar with the new requirements. One medical member of the Mental Health Act Commission visited twenty different hospitals for the purposes of issuing a Certificate of Second Opinion during a four-month period between October 1983 and February 1984. This paper discusses some of the practices and misunderstandings encountered.

scholarly journals Consent to treatment and clinical decision analysis

1989 ◽  
Vol 13 (2) ◽  
pp. 79-81 ◽  
Author(s):  
Ernest P. Worrall
Keyword(s):  
Mental Health ◽  
Drug Treatment ◽  
Decision Analysis ◽  
Medical Practice ◽  
Clinical Decision ◽  
Second Opinion ◽  
England And Wales ◽  
Mental Health Act ◽  
Consent To Treatment ◽  
First Time

The 1984 Scottish Mental Health Act (and its counterpart in England and Wales) invoked unique restrictions in medical practice in this country. For the first time certain standard treatments could not be given to particular patients unless an independent second opinion doctor authorised that treatment. Fortunately, in respect of drug treatment and ECT the second opinion doctors are themselves practising clinicians. Second opinion doctors are asked to give their opinion about the suitability of a proposed treatment using the following guidelines: “the appointed doctor will have in mind his/her understanding of practice accepted as proper by a responsible body of medical men skilled in this particular art in Scotland at this time and should avoid any idiosyncratic view of treatment however firmly held”.

scholarly journals Mental Health Act reform

1999 ◽  
Vol 23 (10) ◽  
pp. 578-581 ◽  
Author(s):  
Trevor Turner ◽  
Mark Salter ◽  
Martin Deahl
Keyword(s):  
Mental Health ◽  
Medical Profession ◽  
Medical Model ◽  
Chief Executive ◽  
Radical Change ◽  
Medical Decision ◽  
Mental Health Act ◽  
Consent To Treatment ◽  
Mental Treatment ◽  
Health Legislation

Psychiatrists have been complaining about mental health legislation for over a century (Smith, 1891), usually in terms of the delays engendered, paperwork and bureaucracy, and the impositions on clinical practice. As a result they have gained more powers, and perhaps much-needed status within the medical profession, to the concern of some commentators (e.g. Fennell, 1996). Thus, the ‘triumph of legalism’ (Jones, 1993) of the Lunacy Act 1890 was modified by the Mental Treatment Act 1930, whereby outpatients and voluntary patients were encouraged and ‘asylums' became ‘mental hospitals'. Then came the radical change of the Mental Health Act (MHA) 1959, making compulsory detention an essentially medical decision and removing the routine of the courts, but retaining a theme of requiring ‘treatment in hospital’. The Mental Health Act 1983, however, was a touch anti-medical, since it strengthened the role of the approved social worker (ASW) and enhanced the importance of a patient's consent to treatment. “The primacy of the medical model and the paramountcy of the psychiatrist are certainly subject to greater limitations and external review”, was the opinion of William Bingley, then Mind's Legal Director, now Chief Executive of the Mental Health Act Commission – reviewing the Act in its early days (Bingley, 1985).

scholarly journals The Mental Health Act 1983 Draft Code of Practice: Mental Health Act Commission's Discussion Paper on Consent to Treatment

1986 ◽  
Vol 10 (8) ◽  
pp. 220-222
Author(s):  
Lord Colville
Keyword(s):  
Mental Health ◽  
Medical Journal ◽  
British Medical Journal ◽  
Discussion Paper ◽  
Draft Code ◽  
Code Of Practice ◽  
Mental Health Act ◽  
Consent To Treatment ◽  
And Function

Professor Bluglass has recently written in the Bulletin on this subject. Articles have also appeared in the British Medical Journal by Dr Hamilton and Professor Kendell. Comments were invited on both documents: to the DHSS on the Code and to MHAC on their paper. To judge by the articles referred to, clarification of the background to and function of both documents is urgently needed.

scholarly journals Consent to Treatment by the Mentally Ill and Mentally Handicapped—An Anomaly in the Mental Health Act 1983

1983 ◽  
Vol 7 (8) ◽  
pp. 145-145 ◽  
Author(s):  
Bridgit C. Dimond
Keyword(s):  
Mental Health ◽  
Mentally Ill ◽  
Short Term ◽  
Mentally Handicapped ◽  
Mental Health Act ◽  
Consent To Treatment

I would like to bring to light an apparent oversight in the new statutory rules relating to consent to treatment by the mentally ill and mentally handicapped. This will have very serious consequences for the management of patients who are on short-term detention orders. The provisions relating to consent to treatment set out in Part IV of the Mental Health Act 1983 are the first attempt to cover by statutory controls the doctor's clinical freedom to prescribe treatment for his compulsorily detained patient. In addition, certain of the new provisions (which take effect from 30 September 1983) apply to the voluntary patients as well.

A survey of the role of allied mental health services in learning disabilities at Lanchester Road Hospital, Durham

2011 ◽  
Vol 26 (S2) ◽  
pp. 900-900
Author(s):  
J. Reddy
Keyword(s):  
Mental Health ◽  
Side Effects ◽  
Mental Health Services ◽  
Health Services ◽  
Blood Pressure Monitoring ◽  
Nursing Assistants ◽  
High Dose ◽  
Charge Nurses ◽  
Blood Tests ◽  
Routine Blood

IntroductionAllied mental health services play important role in patients’ care in Learning Disabilities as they are more in contact with the patients. Their knowledge about common side effects of medication and relevance of routine blood investigations help Clinicians to provide appropriate care and support.ObjectiveTo ascertain the knowledge of Allied mental health services about common side effects of medication and relevance of routine blood investigations.MethodologySurvey questionnaire was distributed to staff between November 09 and January 10.The questions included about the common side effects of Lithium, Insulin, High dose Antidepressants, High dose Antipsychotics and Anticoagulant Medication. Relevance of Routine Blood Tests and Blood Pressure Monitoring were also asked. Number of questionnaire distributed - 60. Number of Respondents -30. Responses were collected anonymously.ResultsRespondent Classification -Registered Nurses- 4, Nursing Assistants- 12, Care Assistants- 10, Associate Practioner- 1, Deputy Charge Nurses- 2, Occupational Therapist -1.Of the Registered Nurses, Associate Practioners, Deputy Charge Nurses the results were 100%. With the Nursing Assistant- 25% (3), Care Assistant- 10% (1) and OT was aware of Routine blood tests and BP.The Nursing Assistants and Care Assistants were aware of one side effect for Lithium, Clozapine, Anticoagulants and Insulin. They were not aware of side effects of High dose Antidepressants & High dose Antipsychotics. The awareness of relevance of Routine Blood Tests and Blood Pressure Monitoring was 80% and 90% respectively.Conclusions•Arrange educational meetings to the Support workers•Conduct the survey in a year's time

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