scholarly journals Implementing the Mental Health Act 2001 in Ireland: views of Irish general practitioners

2013 ◽  
Vol 30 (4) ◽  
pp. 255-259
Author(s):  
F. Jabbar ◽  
M. Aziz ◽  
B. D. Kelly
Keyword(s):  
Mental Health ◽  
General Practitioners ◽  
Best Interests ◽  
Full Potential ◽  
Involuntary Admission ◽  
User Friendliness ◽  
Mental Health Act ◽  
Filling Time ◽  
Negative Comments ◽  
Time Requirements

ObjectivesThe Mental Health Act 2001 introduced important reforms of Irish mental health law and services. This paper aims to provide an evidence-based exploration of general practitioners’ views on the implementation of the Mental Health Act 2001.MethodsWe posted questionnaires to 1200 general practitioners in Ireland seeking their views on their experiences with the Mental Health Act 2001.ResultsEight hundred and twenty general practitioners (68.3%) responded. Among those who provided comments, a majority (75.2%) provided negative comments. The most commonly occurring themes related to difficulties with transport of patients to inpatient facilities, form filling, time requirements and administrative matters. Other negative comments related to general practitioner recommendations for involuntary admission, training, mental health tribunals, applications for involuntary admission and the position of children. Minorities provided neutral (18.0%) or positive comments (6.8%), chiefly related to user-friendliness, transparency and improved communication.ConclusionsGeneral practitioners highlight a need for greater training and clear guidelines in relation to the Mental Health Act 2001. Their forthright responses demonstrate deep engagement with the new legislation and eagerness to see the Mental Health Act 2001 realise its full potential to improve the involuntary admission process and protect human rights, in the best interests of patients.

scholarly journals Reforming the Mental Health Act 1983: ‘Joined Up Compulsion’

2014 ◽  
Vol 1 (5) ◽  
pp. 5
Author(s):  
Philip Fennell
Keyword(s):  
Mental Health ◽  
Learning Disabled ◽  
Legal Framework ◽  
White Paper ◽  
Best Interests ◽  
Mentally Disordered ◽  
Mental Health Act ◽  
Risk Patients ◽  
The Government ◽  
Personality Disordered

<p>This article discusses the two volume White Paper <em>Reforming the Mental Health Act</em> issued by the Government in December 2000. The two volumes are separately titled <em>The New Legal Framework</em> and <em>High Risk Patients</em>. The foreword to the White Paper appears above the signatures of the Secretary of State for Health, Alan Milburn, and the Home Secretary, Jack Straw. This is heralded as an example of ‘joined up government’, and indeed one of the themes of the White Paper is the need for closer working between the psychiatric and criminal justice systems. The primary policy goal of the proposals is the management of the risk posed to other people by people with mental disorder, perhaps best exemplified in Volume One of the White Paper which proclaims that ‘Concerns of risk will always take precedence, but care and treatment should otherwise reflect the best interests of the patient.’ This is a clear reflection of the fact that the reforms are taking place against the background of a climate of concern about homicides by mentally disordered patients, whether mentally ill, learning disabled, or personality disordered.</p>

Clinical predictors of involuntary detention among voluntary inpatients in St Patrick’s University Hospital (SPUH)

2015 ◽  
Vol 34 (1) ◽  
pp. 13-18
Author(s):  
B. Masood ◽  
S. O’Ceallaigh ◽  
T. Thekiso ◽  
M. Nichol ◽  
P. Kowalska-Beda ◽  
...  
Keyword(s):  
Mental Health ◽  
Suicide Risk ◽  
Clinical Characteristics ◽  
University Hospital ◽  
Involuntary Admission ◽  
Clinical Predictors ◽  
Consultant Psychiatrist ◽  
Mental Health Act ◽  
Admission Status ◽  
Act Assessment

BackgroundFew studies have described clinical characteristics of patients subject to an involuntary detention in an Irish context. The Irish Mental Health Act 2001 makes provision under Section 23(1), whereby a person who has voluntary admission status can be detained.AimsThis study aimed to describe all involuntary admissions to St Patrick’s University Hospital (SPUH) (2011–2013) and to evaluate clinical characteristics of voluntary patients who underwent Mental Health Act assessment during 2011 to determine differences in those who had involuntary admission orders completed and those who did not.MethodsAll uses of Mental Health Act 2001 within SPUH 2011–2013 were identified. All uses of Section 23(1) during 2011 were reviewed and relevant documents/case-notes examined using a pro forma covering clinical data, factors recognized to influence involuntary admissions and validated scales were used to determine diagnoses, insight, suicide and violence risk.ResultsOver 2011–2013, 2.5–3.8% of all admissions were involuntary with more detained after use of Section 23(1) than Section 14(2). The majority of initiations of Section 23(1) did not result in an involuntary admission (72%), occurred out of hours (52%) and many occurred early after admission (<1 week, 43%). Initiation of Section 23(1) by a consultant psychiatrist (p=0.001), suicide risk (p=0.03) and lack of patient insight into treatment (p=0.007) predicted conversion to involuntary admission.ConclusionThis study predicts a role for patient insight, suicide risk and consultant psychiatrist decision making in the initiation of Mental Health Act assessment of voluntary patients. Further data describing the involuntary admissions process in an Irish setting are needed.

The development of the role in Ireland of the Authorised Officer (Section 9:1b Mental Health Act 2001) applicant for the involuntary admission to approved centres of persons suffering from mental disorders

2015 ◽  
Vol 32 (4) ◽  
pp. 353-358 ◽  
Author(s):  
F. J. Browne
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Health Service ◽  
Involuntary Admission ◽  
Health Service Executive ◽  
Mental Health Act

This article outlines the development of the role of the Health Service Executive Authorised Officer in Ireland, the professional applicant for the involuntary admission of an adult to hospital beyond that which was envisioned in the Mental Health Act 2001.

scholarly journals Brief Report: Decline in the Use of ECT: The York Study

1987 ◽  
Vol 11 (9) ◽  
pp. 303-304
Author(s):  
Kumud Bhatnagar ◽  
Peter Kennedy ◽  
Stephen Morley
Keyword(s):  
Mental Health ◽  
General Practitioners ◽  
National Survey ◽  
Community Care ◽  
Antidepressant Drug ◽  
Good Deal ◽  
Mental Health Act

A national survey in 1980 drew attention to the wide variation in frequency with which electro-convulsive treatment was being used. Yorkshire Region was at the top of the league with three times the level of the Oxford Region which had the lowest rate. Since then a good deal more research has been published on the effectiveness and limitations of ECT.1–3 Other factors which might have influenced clinicians in their prescribing of this treatment include much stricter conditions in the 1983 Mental Health Act for giving ECT compulsorily, plenty of media comment which may have reduced its acceptability, the increasing confidence of general practitioners in prescribing antidepressant drug therapies, and the greater emphasis on community care.

scholarly journals Mental capacity and psychiatric in-patients: implications for the new mental health law in England and Wales

2009 ◽  
Vol 195 (3) ◽  
pp. 257-263 ◽  
Author(s):  
Gareth S. Owen ◽  
George Szmukler ◽  
Genevra Richardson ◽  
Anthony S. David ◽  
Peter Hayward ◽  
...  
Keyword(s):  
Mental Health ◽  
Assessment Tool ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Mental Capacity ◽  
Best Interests ◽  
Cross Sectional ◽  
England And Wales ◽  
Mental Health Act ◽  
Mental Capacity Act

BackgroundIn England and Wales mental health services need to take account of the Mental Capacity Act 2005 and the Mental Health Act 1983. The overlap between these two causes dilemmas for clinicians.AimsTo describe the frequency and characteristics of patients who fall into two potentially anomalous groups: those who are not detained but lack mental capacity; and those who are detained but have mental capacity.MethodCross-sectional study of 200 patients admitted to psychiatric wards. We assessed mental capacity using a semi-structured interview, the MacArthur Competence Assessment Tool for Treatment (MacCAT–T).ResultsOf the in-patient sample, 24% were informal but lacked capacity: these patients felt more coerced and had greater levels of treatment refusal than informal participants with capacity. People detained under the Mental Health Act with capacity comprised a small group (6%) that was hard to characterise.ConclusionsOur data suggest that psychiatrists in England and Wales need to take account of the Mental Capacity Act, and in particular best interests judgments and deprivation of liberty safeguards, more explicitly than is perhaps currently the case.

Controlled assessment of alcoholics admitted involuntarily to a general psychiatric hospital

1996 ◽  
Vol 13 (4) ◽  
pp. 140-143
Author(s):  
Fionnula O'Loughlin ◽  
Marcus Webb
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Alcohol Dependence ◽  
Psychiatric Hospital ◽  
Involuntary Admission ◽  
Compulsory Admission ◽  
Mental Health Act ◽  
Mental Treatment

AbstractObjective:As the provision for the involuntary admission to hospital of alcoholics is likely to be discarded in a new Irish Mental Health Act, the characteristics of patients committed under the 1945 Irish Mental Treatment Act were explored and compared with those alcoholics admitted voluntarily.Method:All alcoholics admitted compulsorily from 1989-1992 to a general psychiatrichospital in Dublin were compared retrospectively with voluntarily admitted alcoholics. Data was taken from case notes.Results:Results showed that patients admitted compulsorily were older (t = 3.74, df = 62, p < 0.001) and had more physical complications (X2= 8.4, df = 1, p < 0.004) than those admitted voluntarily. Although results did not reach a statistically significant level, there were proportionately more females in the compulsorily admitted group compared with the voluntary group. The outcome of admission overall was better in those admitted voluntarily, although this was influenced both by length of stay and previous admissions for treatment of alcohol dependence. One particularly interesting finding, regardless of admission category, was that duration of admission was statistically significantly longer for women when compared with men.Conclusions:Compulsory admission of alcoholics to a psychiatric hospital for very brief periods was not shown to be strikingly helpful, but this study cannot decide whether or not longer periods of compulsory admission would be valuable.

scholarly journals Involuntary status and mental capacity for treatment decisions under Sections 4, 3, and 57 of Ireland’s Mental Health Act, 2001: analysis and recommendations for reform

2021 ◽  
pp. 1-6
Author(s):  
Katherine Reidy ◽  
Brendan D. Kelly
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Mental Capacity ◽  
Best Interests ◽  
Health Law ◽  
Significant Progress ◽  
Mental Health Act ◽  
Human Rights Based Approach ◽  
Over Time ◽  
Made In

Although significant progress has been made in Irish mental health law in recent decades, the Mental Health Act, 2001 still falls short of properly protecting human rights. A consideration of human rights developments, both domestically and internationally, highlights the urgent need for reform. In this paper we consider Sections 4 (‘Best interests’), 3 (‘Mental disorder’) and 57 (‘Treatment not requiring consent’) of the 2001 Act and related recommendations in the 2015 Report of the Expert Group on the Review of the Mental Health Act, 2001, and suggest specific areas for reform. Just as medicine evolves over time, so too does our understanding of human rights and law. While embracing a human rights-based approach to the extent suggested here might be seen as aspirational, it is important to balance achievable goals with higher ideals if progress is to be made and rights are to be respected.

scholarly journals Safeguards for informal patients

2014 ◽  
pp. 71
Author(s):  
Aswini Weereratne
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Residential Care ◽  
Elderly Person ◽  
Mental Capacity ◽  
Best Interests ◽  
Mental Health Act ◽  
Mental Capacity Act 2005 ◽  
Mental Capacity Act

<p>In light of the plethora of new provisions safeguarding patients who might previously have been cared for and treated informally, it may be instructive to consider who may now be considered a truly informal patient, i.e. one for whom neither process nor formality is needed. When applied to an incapacitated<br />patient requiring treatment for mental disorder, the word “informal” may now seem oxymoronic and possibly redundant. Can such a patient ever be truly informal? Part IV of the model statute suggests that an informal patient is one who lacks capacity and does not object to proposed treatment which is in their best interests, or a patient who may be treated without the use of compulsory powers; but even such a patient must now be subject to some formality if their care or treatment is to be long term or they are to be deprived of their liberty in order to ensure proper safeguards are in place.</p><p>Currently the boundary between the Mental Capacity Act 2005 (“MCA”) and Mental Health Act 1983 (“MHA”) is essentially one determined by whether the patient objects to treatment and is defined with formidable complexity in schedule 1A to the MCA. A patient eligible for MCA deprivation of liberty (“DOL”) safeguards, who could be an elderly person in long term residential care, is now subject to formal<br />processes. There is little true informality for a patient lacking treatment capacity. It is questionable whether even a capacitated patient with mental disorder, who is by definition vulnerable, may be treated informally under the MHA4 if they feel suborned into consenting by the possibility of coercion. The terminology offers a slightly deceptive impression of a benign approach with concomitant levels of<br />autonomy, but while it is appropriate to highlight a difference from compulsory process and keep formality to a minimum for the sake of informality, it is also important not to overplay formality in the name of safeguards. The latter appears to be the vice in which the MCA and MHA is now arguably gripped.</p>

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