scholarly journals Mental Health Act 1983: use of urgent treatment in clinical practice

2013 ◽  
Vol 37 (5) ◽  
pp. 156-159 ◽  
Author(s):  
Rashmi Yadav ◽  
Anthony S. Zigmond
Keyword(s):  
Mental Health ◽  
Information Technology ◽  
Clinical Practice ◽  
Retrospective Study ◽  
Treatment Plan ◽  
Common Reason ◽  
Clinical Implications ◽  
Mental Health Act ◽  
New Treatment ◽  
Established Treatment

Aims and methodTo understand circumstances in which urgent treatment provisions are used in clinical practice, by means of a retrospective study. A list of patients to whom Sections 62, 64B and 64G of the Mental Health Act 1983 were applied during the 1-year study period was obtained from the information technology department. Case notes were traced for detailed information on the circumstances of use of these provisions.ResultsThe most common reason for urgent treatment was to continue the established treatment plan rather than to start a new treatment (45% Section 62, 84% Section 64). The urgent treatment provisions were most commonly used because of a delay in examination by a second opinion appointed doctor in 45% cases for Section 62 and 84% cases for Sections 64B and 64G.Clinical implicationsThis is probably unlawful use of the urgent treatment provisions.

scholarly journals The Mental Health Act 1983

1999 ◽  
Vol 23 (9) ◽  
pp. 534-536 ◽  
Author(s):  
Vijay Bhatti ◽  
Jeremy Kenney-Herbert ◽  
Rosemarie Cope ◽  
Martin Humphreys
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Clinical Practice ◽  
Random Sample ◽  
Clinical Implications ◽  
The West ◽  
Mental Health Act ◽  
West Midlands

Aims and methodA one-in-five random sample (n=104) of practitioners approved under Section 12(2) of the Mental Health Act 1983 in the West Midlands was selected. Opinions were sought on issues relating to current law and potential reform.ResultsEighty-three (80%) doctors were interviewed. Over half (52%) stated that the term ‘mental illness' in the Act was unsatisfactory. Two-thirds (68%) specified the need for a review of legislation relating to treatment in the community.Clinical implicationsThere was a diversity of views. This is likely to be reflected in the clinical practice of those interviewed. Many respondents believed that there was a need for reform in specific areas of the Act.

The impact on clinical practice of the 2015 reforms to the New South Wales Mental Health Act

2016 ◽  
Vol 25 (1) ◽  
pp. 43-47 ◽  
Author(s):  
Christopher James Ryan ◽  
Sascha Callaghan
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Clinical Practice ◽  
Persons With Disabilities ◽  
Mental Health Act ◽  
Recovery Movement ◽  
South Wales ◽  
Management Plans ◽  
Decision Making Model ◽  
The Impact

Objectives: The Mental Health Act 2007 (NSW) ( MHA) was recently reformed in light of the recovery movement and the United Nations Convention on the Rights of Persons with Disabilities. We analyse the changes and describe the impact that these reforms should have upon clinical practice. Conclusions: The principles of care and treatment added to the MHA place a strong onus on clinicians to monitor patients’ decision-making capacity, institute a supported decision-making model and obtain consent to any treatment proposed. Patients competently refusing treatment should only be subject to involuntary treatment in extraordinary circumstances. Even when patients incompetently refuse treatment, clinicians must make every effort reasonably practicable to tailor management plans to take account of any views and preferences expressed by them or made known via friends, family or advance statements.

scholarly journals Variation between services in polypharmacy and combined high dose of antipsychotic drugs prescribed for in-patients

2002 ◽  
Vol 26 (11) ◽  
pp. 418-420 ◽  
Author(s):  
Maria Harrington ◽  
Paul Lelliott ◽  
Carol Paton ◽  
Maria Konsolaki ◽  
Tom Sensky ◽  
...  
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Antipsychotic Drugs ◽  
Service Level ◽  
Case Mix ◽  
Clinical Implications ◽  
High Dose ◽  
Prescribing Practice ◽  
Acute Psychiatric Wards ◽  
High Doses

Aims and MethodA 1-day census provided an opportunity to examine the variation between 44 mental health services in the frequency of prescribing high doses and polypharmacy of antipsychotic drugs to in-patients on acute psychiatric wards.ResultsThe proportion of patients prescribed a high dose ranged 0–50% and simultaneous use of more than one antipsychotic drug ranged 12–71%. A number of case-mix variables explained 26% and 40%, respectively, of the variance between services on these two indicators of prescribing practice.Clinical ImplicationsServices with high rates of prescription of high dose or polypharmacy might consider a review of clinical practice and of service-level factors that might affect prescribing.

scholarly journals Adolescent units: a need for change?

2003 ◽  
Vol 27 (8) ◽  
pp. 292-294 ◽  
Author(s):  
Tim Calton ◽  
Jon Arcelus
Keyword(s):  
Mental Health ◽  
Psychiatric Diagnosis ◽  
Adjustment Disorder ◽  
General Purpose ◽  
Clinical Implications ◽  
Violent Behaviour ◽  
Mental Health Act

Aims and MethodTo describe the characteristics and diagnoses of patients admitted to a general adolescent psychiatric in-patient unit. We describe the age, gender and psychiatric diagnosis of the patient, as well as whether the patient exhibited violent behaviour in the ward, whether he/she needed to be transferred to a different service and whether he/she was admitted under a section of the Mental Health Act 1983.ResultsPatients were evenly distributed in terms of gender, with most being 14–16 years old. Diagnoses were varied with adjustment disorder predominating, but could be separated into four main groups. Levels of violence were high, being associated with detention under the Mental Health Act 1983, and often resulted in transfer to another service.Clinical ImplicationsThe needs of certain adolescents admitted to a general-purpose adolescent unit may not be best met in this environment. Current services must change to meet the needs of their patients. There may be a need for greater specialisation.

scholarly journals Workload implications of the proposed new Mental Health Act – an audit

2003 ◽  
Vol 27 (02) ◽  
pp. 54-57
Author(s):  
Sean Whyte ◽  
Clive Meux
Keyword(s):  
Mental Health ◽  
Clinical Care ◽  
White Paper ◽  
Law Reform ◽  
Clinical Implications ◽  
Health Law ◽  
Forensic Patients ◽  
Mental Health Act ◽  
The Government ◽  
Time Required

Aims and Method To estimate specific time and resource implications for professionals, if proposed changes to the Mental Health Act 1983 (England & Wales) in the Government's white paper were to be implemented unchanged. An audit of time spent on current procedures was extrapolated. Results The amount of time required to comply with the Act will rise substantially (by 27% overall). Social workers and independent doctors will spend 30% and 207% more time respectively, complying with the Act, but psychiatrists providing clinical care to forensic patients should be largely unaffected. Clinical Implications If the Government presses ahead with its plans for mental health law reform as currently proposed, extra resources will be required to provide additional social work and independent medical time – or other services for patients will suffer.

Use of Section 5(2) in clinical practice

1992 ◽  
Vol 16 (01) ◽  
pp. 14-16 ◽  
Author(s):  
Christina Pourgourides ◽  
V. P. Prasher ◽  
Femi Oyebode
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Psychiatric Hospitals ◽  
Annual Basis ◽  
Mental Health Act

The Mental Health Act (1983) came into being eight years ago but few studies into its use have been reported (West, 1987; Sackett, 1987). The Act provided for the setting up of the Mental Health Act Commission to safeguard the interests of detained patients and to monitor the use of the Act. The Commission visits ordinary psychiatric hospitals on an annual basis and writes a report of the visit. The Commission also submits a Biennial Report to Parliament. These reports address important issues but do not provide detailed information on the use of the various sections of the Act in differing hospitals.

scholarly journals When all else fails

1999 ◽  
Vol 23 (11) ◽  
pp. 654-656 ◽  
Author(s):  
Stephen Pereira ◽  
Dominic Beer ◽  
Carol Paton
Keyword(s):  
Mental Health ◽  
Treatment Option ◽  
Oral Treatment ◽  
Clinical Implications ◽  
Small Minority ◽  
Clozapine Treatment ◽  
Blood Tests ◽  
Mental Health Act ◽  
Valuable Treatment ◽  
Treatment Refractory

Aims and methodA small minority of treatment-refractory patients who could benefit from treatment with clozapine, refuse to comply with blood tests or oral treatment. Treatment with clozapine can be enforced under the Mental Health Act.ResultsAn aide memoire was developed locally to guide clinicians through the process of enforcing clozapine treatment.Clinical implicationsIt is possible to enforce treatment with clozapine under the Mental Health Act and so offer a valuable treatment option.

scholarly journals Capacity, compliance and electroconvulsive therapy (ECT): the practice of ECT among consultant psychiatrists

2006 ◽  
Vol 30 (1) ◽  
pp. 13-15 ◽  
Author(s):  
Richard Law-Min ◽  
John Patrick Stephens
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Electroconvulsive Therapy ◽  
Best Practice ◽  
Response Rate ◽  
Common Law ◽  
Good Practice ◽  
Legal Framework ◽  
Clinical Implications ◽  
Clinical Vignettes

Aims and MethodThe aim of this study was to seek the views of consultant psychiatrists on the legal framework they would use when considering treatment with electroconvulsive therapy (ECT). A questionnaire, consisting of three clinical vignettes, was sent to 70 consultants in the Wessex rotation (East Dorset/Hampshire region).ResultsA total of 56 questionnaires were returned; a response rate of 80%. Most consultant psychiatrists agree when giving ECT to capacitated and non-consenting patients. However, there was a lack of consensus when dealing with seemingly incapacitated but compliant patients.Clinical ImplicationsMore clarification in this area is needed. Trusts can assist clinicians by devising their own policies based on nationally agreed standards of best practice. The treatment of mentally incapacitated but compliant patients is an area of practice where uncertainty exists. If proceeding under common law in such cases, it is good practice to discuss with relatives/carers and obtain a second opinion from a consultant colleague. The most recent Bournewood judgement and the new Mental Health Bill will have further implications for clinical practice.

scholarly journals Structured psychiatric assessment schedules – treating the case notes and the patient

2001 ◽  
Vol 25 (11) ◽  
pp. 418-420 ◽  
Author(s):  
Declan Lyons ◽  
Mark Amos ◽  
V. M. Mathew
Keyword(s):  
Clinical Practice ◽  
Psychotropic Medication ◽  
Mental State ◽  
Treatment Plan ◽  
Management Plan ◽  
Clinical Implications ◽  
Plan Quality ◽  
Psychiatric Assessment ◽  
Diagnosis And Management ◽  
Assessment Format

Aims and MethodWe surveyed the usefulness of a structured method of recording history and mental state examinations with a treatment plan in terms of conveying information about diagnosis and management, compared with informal methods of recording data. A survey of admission records by nursing and medical raters was followed by introduction of a standardised assessment format for use by trainees and a re-audit. Initial psychotropic medication was also scrutinised.ResultsThe assessment schedule improved clarity of diagnosis for the medical and nursing raters alike, but improvement in management plan quality was mainly apparent for the medical rater. The audit also exposed widespread use of hypnotic agents.Clinical ImplicationsIt is suggested that structured assessment schedules facilitate adherence to good standards of clinical practice and may benefit trainees undertaking professional exams as well as having a multi-disciplinary and medico-legal relevance.

scholarly journals Perceived Drivers and Barriers to the Adoption of eMental Health by Psychologists: The Construction of the Levels of Adoption of eMental Health Model (Preprint)

2017 ◽  
Author(s):  
Milou A Feijt ◽  
Yvonne AW de Kort ◽  
Inge MB Bongers ◽  
Wijnand A IJsselsteijn
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Clinical Practice ◽  
Mental Health Care ◽  
Health Care Professionals ◽  
Clinical Psychologists ◽  
Qualitative Descriptive ◽  
New Treatment ◽  
Health Model ◽  
Structured Representation

BACKGROUND The internet offers major opportunities in supporting mental health care, and a variety of technology-mediated mental and behavioral health services have been developed. Yet, despite growing evidence for the effectiveness of these services, their acceptance and use in clinical practice remains low. So far, the current literature still lacks a structured insight into the experienced drivers and barriers to the adoption of electronic mental health (eMental health) from the perspective of clinical psychologists. OBJECTIVE The aim of this study was to gain an in-depth and comprehensive understanding of the drivers and barriers for psychologists in adopting eMental health tools, adding to previous work by also assessing drivers and analyzing relationships among these factors, and subsequently by developing a structured representation of the obtained findings. METHODS The study adopted a qualitative descriptive approach consisting of in-depth semistructured interviews with clinical psychologists working in the Netherlands (N=12). On the basis of the findings, a model was constructed that was then examined through a communicative validation. RESULTS In general, a key driver for psychologists to adopt eMental health is the belief and experience that it can be beneficial to them or their clients. Perceived advantages that are novel to literature include the acceleration of the treatment process, increased intimacy of the therapeutic relationship, and new treatment possibilities due to eMental health. More importantly, a relation was found between the extent to which psychologists have adopted eMental health and the particular drivers and barriers they experience. This differentiation is incorporated in the Levels of Adoption of eMental Health (LAMH) model that was developed during this study to provide a structured representation of the factors that influence the adoption of eMental health. CONCLUSIONS The study identified both barriers and drivers, several of which are new to the literature and found a relationship between the nature and importance of the various drivers and barriers perceived by psychologists and the extent to which they have adopted eMental health. These findings were structured in a conceptual model to further enhance the current understanding. The LAMH model facilitates further research on the process of adopting eMental health, which will subsequently enable targeted recommendations with respect to technology, training, and clinical practice to ensure that mental health care professionals as well as their clients will benefit optimally from the current (and future) range of available eMental health options.

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