scholarly journals Section 12 approval: fit for purpose?

2019 ◽  
Vol 43 (6) ◽  
pp. 251-254 ◽  
Author(s):  
David Rigby ◽  
Lynsey McAlpine
Keyword(s):  
Mental Health ◽  
Royal College ◽  
Summative Assessment ◽  
Learning Objectives ◽  
Evidence Based ◽  
Knowledge And Skills ◽  
Mental Health Act ◽  
Fit For Purpose ◽  
Educational Perspective ◽  
The Uk

SummaryIn light of the increasing numbers of detentions of mentally unwell patients in the UK and the recent review of the Mental Health Act, this editorial seeks to analyse the process of Section 12 approval of doctors from a medical educational perspective. We compare the approval mechanisms with assessments in other specialities and suggest evidence-based improvements. We believe that a rethinking of the Royal College of Psychiatrists' learning objectives for Section 12 approval and the introduction of a summative assessment would improve the knowledge and skills of clinicians performing an important and scrutinised role within our society.

scholarly journals The Montgomery ruling, individual values and shared decision-making in psychiatry

2018 ◽  
Vol 24 (2) ◽  
pp. 93-100 ◽  
Author(s):  
Julian C. Hughes ◽  
David Crepaz-Keay ◽  
Charlotte Emmett ◽  
K. W. M. Fulford
Keyword(s):  
Mental Health ◽  
Decision Making ◽  
Shared Decision Making ◽  
Learning Objectives ◽  
Evidence Based ◽  
List Type ◽  
Shared Decision ◽  
Individual Values ◽  
The Uk

SUMMARYThis article starts with a brief review of the UK Supreme Court's decision in the Montgomery case. Although much of the focus in discussing the case has been on the disclosure of risk, an important aspect of the model of consent contained in the judgment is that of dialogue. The model of informed consent set out in Montgomery suggests shared decision-making as the norm. Central to shared decision-making, however, is an awareness of values and of how values can vary between people. We introduce values-based practice as an approach that is entirely in keeping with the precepts of the Montgomery judgment. We go on to review how values-based practice and shared decision-making are relevant to psychiatric practice, using as examples recovery practice and compulsory detention under the Mental Health Act 1983.LEARNING OBJECTIVES•Appreciate that a new test of consent has been established as of a result of the UK Supreme Court's Montgomery ruling•Learn about the role of values-based practice as a partner to evidence-based practice in implementing Montgomery•Understand how values-based practice and Montgomery together support shared decision-making in psychiatryDECLARATION OF INTERESTNone.

scholarly journals Brief Behavioural Activation (Brief BA) for Adolescent Depression: A Pilot Study

2017 ◽  
Vol 46 (2) ◽  
pp. 182-194 ◽  
Author(s):  
Laura Pass ◽  
Carl W. Lejuez ◽  
Shirley Reynolds
Keyword(s):  
Mental Health ◽  
Pilot Study ◽  
Young People ◽  
Adolescent Depression ◽  
Psychological Intervention ◽  
Clinical Effectiveness ◽  
Evidence Based ◽  
Behavioural Activation ◽  
Evidence Based Treatments ◽  
The Uk

Background: Depression in adolescence is a common and serious mental health problem. In the UK, access to evidence-based psychological treatments is limited, and training and employing therapists to deliver these is expensive. Brief behavioural activation for the treatment of depression (BATD) has great potential for use with adolescents and to be delivered by a range of healthcare professionals, but there is limited empirical investigation with this group. Aims: To adapt BATD for depressed adolescents (Brief BA) and conduct a pilot study to assess feasibility, acceptability and clinical effectiveness. Method: Twenty depressed adolescents referred to the local NHS Child and Adolescent Mental Health service (CAMHs) were offered eight sessions of Brief BA followed by a review around one month later. Self- and parent-reported routine outcome measures (ROMs) were collected at every session. Results: Nineteen of the 20 young people fully engaged with the treatment and all reported finding some aspect of Brief BA helpful. Thirteen (65%) required no further psychological intervention following Brief BA, and both young people and parents reported high levels of acceptability and satisfaction with the approach. The pre–post effect size of Brief BA treatment was large. Conclusions: Brief BA is a promising innovation in the treatment of adolescent depression. This approach requires further evaluation to establish effectiveness and cost effectiveness compared with existing evidence-based treatments for adolescent depression. Other questions concern the effectiveness of delivery in other settings and when delivered by a range of professionals.

scholarly journals Fidelity to an evidence-based model for crisis resolution teams: a cross-sectional multicentre study in Norway

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
N. Hasselberg ◽  
K. H. Holgersen ◽  
G. M. Uverud ◽  
J. Siqveland ◽  
B. Lloyd-Evans ◽  
...  
Keyword(s):  
Mental Health ◽  
Multidisciplinary Teams ◽  
Evidence Based ◽  
Crisis Resolution ◽  
Health Crisis ◽  
The Core ◽  
Crisis Resolution Teams ◽  
Fidelity Scale ◽  
The Uk ◽  
Evidence Based Model

Abstract Background Crisis resolution teams (CRTs) are specialized multidisciplinary teams intended to provide assessment and short-term outpatient or home treatment as an alternative to hospital admission for people experiencing a mental health crisis. In Norway, CRTs have been established within mental health services throughout the country, but their fidelity to an evidence-based model for CRTs has been unknown. Methods We assessed fidelity to the evidence-based CRT model for 28 CRTs, using the CORE Crisis Resolution Team Fidelity Scale Version 2, a tool developed and first applied in the UK to measure adherence to a model of optimal CRT practice. The assessments were completed by evaluation teams based on written information, interviews, and review of patient records during a one-day visit with each CRT. Results The fidelity scale was applicable for assessing fidelity of Norwegian CRTs to the CRT model. On a scale 1 to 5, the mean fidelity score was low (2.75) and with a moderate variation of fidelity across the teams. The CRTs had highest scores on the content and delivery of care subscale, and lowest on the location and timing of care subscale. Scores were high on items measuring comprehensive assessment, psychological interventions, visit length, service users’ choice of location, and of type of support. However, scores were low on opening hours, gatekeeping acute psychiatric beds, facilitating early hospital discharge, intensity of contact, providing medication, and providing practical support. Conclusions The CORE CRT Fidelity Scale was applicable and relevant to assessment of Norwegian CRTs and may be used to guide further development in clinical practice and research. Lower fidelity and differences in fidelity patterns compared to the UK teams may indicate that Norwegian teams are more focused on early interventions to a broader patient group and less on avoiding acute inpatient admissions for patients with severe mental illness.

A retrospective cohort study describing characteristics of those repeatedly detained under Section 136 of the Mental Health Act over a 5-year period and the association with past abuse

2021 ◽  
pp. 002580242110454
Author(s):  
Laureen Adewusi ◽  
Isabel Mark ◽  
Paige Wells ◽  
Aileen O’Brien
Keyword(s):  
Mental Health ◽  
Past History ◽  
Significant Proportion ◽  
Community Support ◽  
White Ethnicity ◽  
Demographic Profiles ◽  
Mental Health Act ◽  
History Of ◽  
Self Harm ◽  
The Uk

Individuals repeatedly detained under Section 136 (S136) of the Mental Health Act account for a significant proportion of all detentions. This study provides a detailed analysis of those repeatedly detained (‘repeat attenders’) to a London Mental Health Trust, identifying key demographic profiles when compared to non-repeat attenders, describing core clinical characteristics and determining to what degree a past history of abuse might be associated with these. All detentions to the S136 suite at South West London and St George's Mental Health NHS Trust over a 5-year period (2015–2020) were examined. Data were collected retrospectively from electronic records. A total of 1767 patients had been detained, with 81 patients identified as being a ‘repeat attenders’ (having had > = 3 detentions to the S136 suite during the study period). Repeat attenders accounted for 400 detentions, 17.7% of all detentions. Repeat attenders included a higher proportion of females (49.4%, p = 0.0001), compared to non-repeat attenders, and a higher proportion of them were of white ethnicity (85.2%, p = 0.001). 52 (64%) patients reported being a victim of past abuse or trauma. Of repeat attenders who reported past abuse or trauma, a high proportion had diagnoses of personality disorders, with deliberate self-harm as the most common reason for detention. They were more commonly discharged home with community support, rather than considered for hospital admission. In light of these findings, this paper discusses support potential strategies for those most vulnerable to repeated S136 detention, thereby minimising the ever-growing number of S136 detentions in the UK.

7. Mental Health Law

Medical Law ◽  
2019 ◽  
pp. 351-419
Author(s):  
Emily Jackson
Keyword(s):  
Mental Health ◽  
Community Treatment ◽  
Health Law ◽  
Persons With Disabilities ◽  
Mental Health Law ◽  
Mental Health Act ◽  
Independent Review ◽  
History Of ◽  
Human Rights Act ◽  
The Uk

All books in this flagship series contain carefully selected substantial extracts from key cases, legislation, and academic debate, providing able students with a stand-alone resource. This chapter discusses mental health law in the UK. It begins with a brief history of mental health law and policy. This is followed by discussions of: admission to the mental health system; treatment of the mentally ill under the Mental Health Act 1983; Deprivation of Liberty Safeguards (DoLS) and Cheshire West, and Community Treatment Orders. It also looks at the implications of the Human Rights Act and the UN Convention on the Rights of Persons with Disabilities (UNCRPD) for mental health law. It also considers the conclusions of the Independent Review of the Mental Health Act 1983.

Values based psychiatry

2011 ◽  
Vol 26 (S2) ◽  
pp. 2128-2128
Author(s):  
B.K.W.M. Fulford
Keyword(s):  
Mental Health ◽  
Clinical Decision Making ◽  
Clinical Skills ◽  
Clinical Decision ◽  
Evidence Based ◽  
Involuntary Treatment ◽  
New Approach ◽  
Health Values ◽  
Potential Partner ◽  
The Uk

Values-based Practice is a new approach to working with complex and conflicting values in medicine. The approach is derived from work in analytic philosophy on the logic of values. As a practical approach, it is based primarily on learnable clinical skills. Values-based Practice has been developed particularly in mental health, through a number of programmes involving both voluntary sector and government organisations in the UK and internationally. Two examples of these programmes will be presented: one related to the use of involuntary treatment in psychiatry; the other arising from a government-sponsored programme on diagnosis and assessment in mental health. Values-based Practice is currently being extended into other areas of medicine as a potential partner to evidence-based practice in clinical decision making

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