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.

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).

Detention of In-Patients under Section 5(2) of the Mental Health Act 1983

1998 ◽  
Vol 38 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Emad Salib ◽  
Boni Iparragirre
Keyword(s):  
Mental Health ◽  
Hospital Stay ◽  
Clinical Diagnosis ◽  
Length Of Hospital Stay ◽  
The Other ◽  
Short Term ◽  
Time Of Application ◽  
Mental Health Act ◽  
Equal Chance

All applications of s.5(2) of the Mental Health Act 1983, allowing the emergency detention of voluntary in-patients in North Cheshire between 1985 and 1995, were reviewed to examine general trends in its use and to assess variables likely to influence its outcome. Of the 877 applications implemented (4% of all admissions), 500 (57%) were converted to longer-term detention under the Act, 396 (45%) were converted to s.2 and 104 (12%) to s.3. The other 377 (43%) detained patients under s.5(2) regained informal status. The review found that time of application of section, length of hospital stay prior to application, medical officer's grade, use of s.5(4) and clinical diagnosis are best predictors of s.5(2) outcome. The results are similar to other published studies and seem to reflect a national pattern, possibly implying that patients detained under this short-term detention order have an almost equal chance of either regaining their voluntary status or being detained under another section by the end of the 72 hours. This may raise questions about the purpose of s.5(2) as expressed by the Mental Health Act Commission.

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.

Doctors' Holding Power in Practice: Section 5(2) of the Mental Health Act 1983

1995 ◽  
Vol 35 (3) ◽  
pp. 231-236 ◽  
Author(s):  
A D Hall ◽  
B K Puri ◽  
T Stewart ◽  
P S Grahame
Keyword(s):  
Mental Health ◽  
Psychotic Disorder ◽  
Psychiatric Service ◽  
Patient Admission ◽  
Case Note ◽  
Short Term ◽  
Affective Psychosis ◽  
Mental Health Act ◽  
Holding Power ◽  
Large Catchment

Section 5(2) of the Mental Health Act 1983 (England and Wales) is a commonly used short term power of detention often implemented by junior medical staff, which has no statutory right of appeal. There is little published analysis of its use in clinical practice. A detailed case note study of its use in a psychiatric service with a large catchment area is presented. Fifty-seven per cent of the patients detained under s.5(2) were female. Affective psychosis was over-represented in detained females, while schizophrenia and paranoid states were over-represented in males. Eight per cent of s.5(2) detentions were initiated via the nurses' holding power, s.5(4). None of these patients were subsequently regraded to s.2 or 3, which may be accounted for by the finding that personality disorder and alcohol dependence were more commonly diagnosed in this subgroup. Of s.5(2) detainees, none of those with a non-psychotic disorder were regraded to s.2 or 3. Three patients had not accepted in-patient admission prior to implementation of s.5(2). Moreover, 38 per cent of all s.5(2) detentions took place within 24 hours of admission. Patients with a psychotic disorder were more likely to be detained within 24 hours of admission. Doubts regarding the validity of consent to voluntary admission in these patients are raised.

The Spectre of Criminalization: Remand Admissions to the Forensic Psychiatric Institute, British Columbia, 1975–1990

1996 ◽  
Vol 36 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Philip M J Brinded ◽  
Faye E Grant ◽  
Jeanette E Smith
Keyword(s):  
Mental Health ◽  
British Columbia ◽  
Mentally Ill ◽  
Psychiatric Institute ◽  
Mental Health Act ◽  
History Of ◽  
Forensic Psychiatric

The history of the Forensic Psychiatric Institute (FPI) of British Columbia is reviewed through a description of the 3,500 remand admissions to the Institute between 1975 and 1990. Individuals charged with only minor offences and those who were certified under the Mental Health Act 1983 and subsequently had their charges stayed are examined in more detail. Results appear to suggest that these two groups are particularly vulnerable to the process of criminalization. The possible link between criminalization of the mentally ill and deinstitutionalization is explored.

scholarly journals Detention – the grey area

1989 ◽  
Vol 13 (1) ◽  
pp. 12-13
Author(s):  
Oscar E. Daly
Keyword(s):  
Mental Health ◽  
Mentally Ill ◽  
Large Degree ◽  
Mental Health Act ◽  
Sexual Deviancy ◽  
Grey Area ◽  
Management Procedures ◽  
The Government

In September 1978 the Government published a review of the Mental Health Act (1959). This review was prompted to a large degree by an increasing awareness of the rights of the mentally ill and by an awareness among psychiatrists of the limits of their management procedures. The proposals of this review were largely incorporated into the Mental Health Act (1983). Among the proposals so incorporated was one that persons could not be detained in hospital against their will for assessment or treatment “by reason only of promiscuity or other immoral conduct, sexual deviancy or dependence on alcohol or drugs”.

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