scholarly journals Least restrictive alternative – advance statements and the new mental health legislation

2002 ◽  
Vol 26 (7) ◽  
pp. 246-247 ◽  
Author(s):  
J. M. Atkinson ◽  
H. C. Garner
Keyword(s):  
Mental Health ◽  
Home Office ◽  
Policy Makers ◽  
Department Of Health ◽  
Mental Health Legislation ◽  
Advance Statements ◽  
Restrictive Environment ◽  
The Patient’S View ◽  
Health Legislation ◽  
Least Restrictive Alternative

Proposals for new mental health legislation make the case for using the ‘least restrictive alternative’ (Scottish Executive, 2001) and the ‘least restrictive environment’ (Department of Health & Home Office, 2000) as guiding principles in deciding the management and treatment of the patient. This appears to be the case made for introducing compulsory treatment in the community. The patient living in the community, while maintained on medication, rather than the hospital would appear to be defined as on the ‘least restrictive alternative’. This, however, takes only a limited approach to what is ‘restrictive’, which should be interpreted more widely, including the patient's view as well as that of clinicians and policy makers. Thus, a patient may see it as less restrictive during an acute phase to be in hospital and not on medication, than in the community but on medication. It is likely, given our knowledge of patients' attitudes to medication (Eastwood & Pugh, 1997), that many patients will prefer to be on oral medication rather than depot, which they see as less restrictive.

scholarly journals Intensive home treatment, admission rates and use of mental health legislation

2010 ◽  
Vol 34 (12) ◽  
pp. 522-524 ◽  
Author(s):  
Naida F. Forbes ◽  
Helen T. Cash ◽  
Stephen M. Lawrie
Keyword(s):  
Mental Health ◽  
Home Treatment ◽  
Treatment Team ◽  
Admission Rates ◽  
Duration Of Hospital Stay ◽  
Mental Health Legislation ◽  
Local Impact ◽  
Health Legislation ◽  
Least Restrictive Alternative ◽  
Alternative Principle

Aims and methodWe examined the local impact of introducing a home treatment team on the use of in-patient psychiatric resources and rates of detention under the Mental Health (Care and Treatment) (Scotland) Act 2003.ResultsRates of admission to hospital and duration of hospital stay were unchanged. However, there was an increase in episodes of detention in the year following the team's introduction.Clinical implicationsOffering home treatment as an alternative to in-patient care may be associated with an increase in compulsory treatment. If true, this is incompatible with the ‘least restrictive alternative’ principle of the recently revised mental health legislation.

scholarly journals The Home Office Mental Health Unit

1996 ◽  
Vol 20 (12) ◽  
pp. 742-743
Author(s):  
J. M. Potts
Keyword(s):  
Mental Health ◽  
Rapid Response ◽  
Health Unit ◽  
Home Office ◽  
Mentally Disordered ◽  
Separate Section ◽  
Mental Health Legislation ◽  
Health Legislation ◽  
Mental Health Unit

On 1 April the mental health section of the Home Office's C3 Division was renamed “Mental Health Unit”, as part of a wider initiative to streamline the Department and give more meaningful titles to the various different areas of work. The responsibilities of our Unit remain the same, however. First, we deal with the cases of restricted patients under mental health legislation. As well as advising Ministers or taking decisions on their behalf about leave, transfers and discharge, the Unit also authorises the transfer of mentally disordered prisoners to hospital. This prison transfer work is focused in a separate section of the Unit which is able to provide a very rapid response to urgent requests for transfer warrants. The number of transfers has gone up from 337 in 1990 to over 700 in each of the last three years.

scholarly journals Jurisdiction of Mental Health Tribunals to Provide Positive Remedies: Application, Challenges, and Prospects

2012 ◽  
Vol 57 (2) ◽  
pp. 267-298
Author(s):  
Joaquin Zuckerberg
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Civil Rights ◽  
Mentally Ill ◽  
Policy Makers ◽  
Adequate Care ◽  
Mental Health Legislation ◽  
The Right ◽  
Health Legislation ◽  
State Interference

Modern mental health legislation protects the civil rights of the mentally ill by limiting the scope of permissible state interference with an individual’s autonomy. It also generally sets up mental health tribunals in charge of reviewing compliance with parts of the legislation. However, the legislation does not generally address the right to adequate mental health care. The latter (or its lack thereof) has increasingly become a source of debate among scholars and policy makers. The right to adequate care is increasingly being seen as the sine qua non of the civil rights of the mentally ill. This article explores recent Canadian jurisprudence dealing with the power of administrative tribunals to address constitutional and quasi-constitutional claims, and questions whether such power could give rise to a claim for adequate health care before mental health tribunals. It argues that, subject to some limited circumstances where mental tribunals have been given certain discretion to factor adequate care into their decisions, the recent Canadian jurisprudence does not significantly modify the limited remedies available before mental health tribunals.

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 Murmurs of discontent: treatment and treatability of personality disorder

2001 ◽  
Vol 7 (6) ◽  
pp. 407-415 ◽  
Author(s):  
Gwen Adshead
Keyword(s):  
Mental Health ◽  
White Paper ◽  
Involuntary Admission ◽  
Department Of Health ◽  
Legal Term ◽  
Mental Health Legislation ◽  
It Department ◽  
Health Legislation ◽  
Legal Sense ◽  
Considerable Discussion

“They murmured, as they took their fees ‘There is no cure for this disease’.”Hilaire BellocTreatability is a confused and confusing concept in psychiatry. In its legal sense, it is a measure that limits the involuntary admission of patients with some particular types of mental disorder. The legal term itself has generated considerable discussion and dissent (e.g. Mawson, 1983; Grounds, 1987), and the Government's White Paper on reforming mental health legislation in England and Wales proposes to abolish it (Department of Health, 2000).

scholarly journals Proportionality of legal discrimination

2010 ◽  
Vol 7 (1) ◽  
pp. 24-24
Author(s):  
Partha Gangopadhyay
Keyword(s):  
Mental Health ◽  
Code Of Practice ◽  
Department Of Health ◽  
Mental Health Legislation ◽  
Mental Capacity Act 2005 ◽  
Legal Duty ◽  
The Government ◽  
Mental Capacity Act ◽  
The Uk ◽  
Health Legislation

Sir: The article by Zigmond (2009) made for interesting reading. Mental health law is about balancing the need to detain people in order to protect them or other people from harm and the need to respect people's human rights and autonomy. In the UK, there was much concern during the development of recent mental health legislation, in particular the Mental Capacity Act 2005, that the government had got this balance wrong. Many of these concerns have been addressed in the updated Code of Practice to the 1983 Mental Health Act, which is an essential guide to practising under the Act (Department of Health, 2008). There is no legal duty to comply with the Code, but professionals must have regard to it and record the reason for any departure from the guidance (which can be subject to legal challenge).

scholarly journals Dangerous severe personality disorder

2003 ◽  
Vol 9 (5) ◽  
pp. 349-358 ◽  
Author(s):  
Adrian Feeney
Keyword(s):  
Mental Health ◽  
Personality Disorder ◽  
Present Situation ◽  
Department Of Health ◽  
Mental Health Legislation ◽  
Treatment Models ◽  
Draft Bill ◽  
Health Legislation ◽  
The Relationship ◽  
Severe Personality Disorder

The Draft Mental Health Bill was published in June 2002 and was widely criticised. There were particular concerns regarding the possible detention of those with personality disorders solely for the protection of the general public. Subsequently the Draft Bill was omitted from the Queen's speech in November 2002. The Department of Health has stated that it intends to push for the Bill's inclusion in the next Parliamentary year. This review attempts to summarise the present situation so as to inform the debate. It considers the relationship between personality disorder and risk, with examination of treatment models and the existing and proposed mental health legislation.

scholarly journals Foreword

2014 ◽  
pp. 97
Author(s):  
Charlotte Emmett
Keyword(s):  
Mental Health ◽  
White Paper ◽  
Department Of Health ◽  
Mental Health Legislation ◽  
Health Legislation

<p align="left">It seems probable that publication of this issue of the Journal will coincide with publication by the Department of Health of the eagerly awaited White Paper containing the Government’s intended reform of mental health legislation.</p>

scholarly journals Code of Practice 1999: navigating before reform of the Mental Health Act 1983

2000 ◽  
Vol 6 (1) ◽  
pp. 3-4
Author(s):  
Julian C. Hughes ◽  
Tony Lawson
Keyword(s):  
Mental Health ◽  
Public Safety ◽  
Green Paper ◽  
Code Of Practice ◽  
Mental Health Act ◽  
Department Of Health ◽  
Mental Health Legislation ◽  
Health Legislation

Mental health legislation must steer a course between Scylla and Charybdis. Scylla represents the notion of individual liberties; Charybdis represents the notion of safety and, in particular, public safety. At the time of writing a Green Paper is expected in 1999, so reform of the Mental Health Act 1983 is on its way. Meanwhile, does the new Code of Practice (Department of Health & Welsh Office, 1999), in force since 1 April 1999, give us any indication as to the course we might be steering?

scholarly journals Advance statements: survey of patients' views and understanding

2007 ◽  
Vol 31 (9) ◽  
pp. 339-341 ◽  
Author(s):  
Jane Foy ◽  
Alison Macrae ◽  
Alex Thom ◽  
Ajay Macharouthu
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Treatment Preferences ◽  
Clinical Implications ◽  
Loss Of Control ◽  
Mental Health Legislation ◽  
Advance Statements ◽  
Types Of Information ◽  
Health Legislation

Aims and MethodA survey of patients was undertaken to determine their knowledge and understanding of advance statements (a new addition to Scottish mental health legislation introduced with the Mental Health (Care and Treatment) (Scotland) Act 2003). Few patients have taken up this facility and this study attempts to identify potential explanations.ResultsA minority of the initial 58 participants had heard of advance statements prior to the survey (5 of 58, 8.6%). After issuing information about advance statements, awareness and understanding increased significantly among those who completed the study, with 59% (16 of 27) now understanding the concept. The types of information that patients wished to be documented in an advance statement fell into two broad groups: treatment preferences and statements regarding loss of control and autonomy. Out of 27 participants 19 (70%) stated they would now consider drawing up an advance statement.Clinical ImplicationsA lack of knowledge among patients about the existence of advance statements is highlighted. After a brief intervention, awareness, understanding and interest increased significantly, suggesting that poor uptake could be because of lack of awareness. Most participants would consult mental health professionals when drawing up an advance statement, therefore we have a responsibility to be fully informed about the process.

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