scholarly journals Compulsory admission and involuntary treatment in Portugal

2016 ◽  
Vol 13 (1) ◽  
pp. 17-19 ◽  
Author(s):  
Telma Almeida ◽  
Andrew Molodynski

This paper details the grounds for compulsory treatment, compulsory admissions in an emergency department and compulsory out-patient treatment in Portugal. Portuguese mental health legislation has improved significantly over recent years, with enhanced safeguards, rapid and rigorous review and clear criteria for compulsory treatment, although much remains to be done, especially in relation to the ‘move into the community’.

1995 ◽  
Vol 19 (1) ◽  
pp. 45-47 ◽  
Author(s):  
John Hambridge ◽  
Nicola Watt

The New South Wales Mental Health Act (1990) heralded a number of important changes to mental health legislation in the state. One of these was the option to give compulsory treatment to mentally ill clients living in the community. This article briefly explains community treatment under the Act, and the perceived benefits and the limitations of such legislation. A case example is used to illustrate some of these points. Involuntary community treatment is seen as a less restrictive alternative to hospitalisation for a number of mentally ill clients, but the use of such provisions demands significant resources from the supervising agency.


2005 ◽  
Vol 186 (1) ◽  
pp. 54-59 ◽  
Author(s):  
Dana S. Rose ◽  
Til H. Wykes ◽  
Jonathan P. Bindman ◽  
Pete S. Fleischmann

BackgroundElectroconvulsive therapy (ECT) is a procedure that attracts special safeguards under common law for voluntary patients and under both current and proposed mental health legislation, for those receiving compulsory treatment.AimsTo review patients' views on issues of information, consent and perceived coercion.MethodSeventeen papers and reports were identified that dealt with patients' views on information and consent in relation to ECT; 134 ‘testimonies' or first-hand accounts were identified. The papers and reports were subjected to a descriptive systematic review. The testimony data were analysed qualitatively.ResultsApproximately half the patients reported that they had received sufficient information about ECT and side-effects. Approximately a third did not feel they had freely consented to ECTeven when they had signed a consent form. Clinician-led research evaluates these findings to mean that patients trust their doctors, whereas user-led work evaluates similar findings as showing inadequacies in informed consent.ConclusionNeither current nor proposed safeguards for patients are sufficient to ensure informed consent with respect to ECT, at least in England and Wales.


2002 ◽  
Vol 8 (3) ◽  
pp. 180-188 ◽  
Author(s):  
Steffan Davies

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.


2016 ◽  
Vol 13 (2) ◽  
pp. 43-45 ◽  
Author(s):  
Ian Soosay ◽  
Rob Kydd

New Zealand has an established history of mental health legislation that sits within a framework of human rights, disability and constitutional protections. We outline a brief history of mental health legislation in New Zealand since its inception as a modern state in 1840. The current legislation, the Mental Health (Compulsory Assessment and Treatment) Act 1992, defines mental disorder and the threshold for compulsory treatment. We describe its use in clinical practice and the wider legal and constitutional context which psychiatrists need to be aware of in their relationships with patients.


2018 ◽  
Vol 2017 (24) ◽  
pp. 87
Author(s):  
Christopher Maylea ◽  
Christopher James Ryan

<p>The United Nations Convention on the Rights of Persons with Disabilities (CRPD) has led to a re-thinking of traditional mental health law around the world. Since Australia’s ratification of the CRPD, all but one of its eight jurisdictions have introduced reforms to mental health legislation. These are aimed, in part, towards compliance with the Conventions articles. This paper examines the meaning and operation of the reforms introduced in Australia’s second most populous state – Victoria.</p><p><br />We first describe the criteria for involuntary treatment set out in the new <em>Mental Health Act 2014</em> (Vic) (Austl.) (the Act). We then argue that when making an order for Involuntary Treatment, the Victorian Mental Health Tribunal (the Tribunal) is obliged to carefully consider a person’s decision-making capacity as part of ensuring that treatment is provided in the least restrictive way, and to only authorise the involuntary treatment over a person’s competent objection in very limited circumstances.</p><p><br />Having established the way in which the Act <em>should</em> operate, we then present two empirical studies which analyse the decisions of the Statements of Reasons of the Tribunal to gain some appreciation of how the Act is working. These indicate that seldom does the Tribunal consider the decision-making capacity of people brought before it, and that, even when this is considered, the relevant information is not being used protectively so as to uphold a right to competently refuse treatment. Instead, the Tribunal uses the presence or absence of decision-making capacity, insight or poor judgement, to determine if a person is mentally ill or if treatment is required to prevent serious harm. We conclude that the Tribunal’s practice is inconsistent with the principles of the Act and consequently the intention of Parliament.</p>


Author(s):  
George Szmukler

Substantial problems attach to both of the fundamental criteria that need to be met for involuntary treatment in conventional mental health legislation—the presence of a ‘mental disorder’ and a risk of harm to self or others. The boundaries of ‘mental disorder’ are of necessity loosely drawn, with substantial blurring at the edges and contested views about where these should lie. ‘Values’—for example, when does ‘sadness’ become a ‘depressive illness’—play a significant role in determining when a diagnosis of a ‘disorder’ is warranted. Precision in the assessment of ‘risk’ is poor, especially for those infrequent or rare harms that we are most concerned to prevent. In general psychiatric practice, the prediction of suicide or serious acts of violence to others is of severely limited value. Even with ‘state-of-the-art’ risk assessment measures, ‘false positives’ overwhelm ‘true positives’. Significant costs attach to an emphasis on risk assessment.


2007 ◽  
Vol 31 (3) ◽  
pp. 101-103 ◽  
Author(s):  
Hanna Putkonen ◽  
Birgit Vollm

Despite efforts to integrate and harmonise legislation across the member states of the European Union (EU), mental health legislation, including legislation for the detention and treatment of offenders with mental disorders, differs widely across Europe. With changes to the Mental Health Act 1983 in the UK currently underway, investigating the different approaches to compulsory psychiatric care in other countries can be a stimulating and worthwhile exercise. We explored the Finnish mental health law with regard to compulsory admission and treatment and forensic care. Relevant differences between the Finnish approach and legislation in other European countries will be discussed.


1988 ◽  
Vol 51 (9) ◽  
pp. 307-311
Author(s):  
Bridgit Dimond

The occupational therapist is increasingly likely to be concerned with the care of mentally disordered people. Some provisions of the Mental Health Act 1983 affect him/her directly. This article discusses some of the most important provisions of the mental health legislation, in particular compulsory admission, consent to treatment provisions, the duties of the manager to inform the patient and the definition and powers of the nearest relative.


2008 ◽  
Vol 14 (2) ◽  
pp. 89-97 ◽  
Author(s):  
Donald Lyons

The Mental Health (Care and Treatment) (Scotland) Act 2003 was implemented in October 2005. This article summarises the main features of the Act and its differences from previous legislation. The Act was intended to provide a more flexible range of interventions, including compulsory treatment in the community. It also introduced a number of new safeguards. These are described and early data on their impact are presented. Some provisions of the Act are time-consuming and cumbersome, but there is evidence that psychiatrists are committed to its principles and this is borne out by early monitoring data. Some aspects of the Act are being reviewed at the time of writing.


Author(s):  
Alec Buchanan

<p>Calls for a new Mental Health Act for England and Wales, and the government’s response to those calls, raise the question of why we have mental health legislation. One answer is that we wish to provide criteria for psychiatric detention and compulsory treatment. It is argued that we are willing to coerce some people with mental disorders in this way when we conclude that their ability to make a proper choice is impaired. Mental health legislation could and should be designed to take this into account.</p>


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