Detention of ‘Psychopathic Disorder’ Patients in Special Hospitals Critical Issues

1987 ◽  
Vol 151 (4) ◽  
pp. 474-478 ◽  
Author(s):  
A. T. Grounds
Keyword(s):  
Mental Health ◽  
Legal Framework ◽  
Psychological Change ◽  
Mental Health Act ◽  
Critical Issues ◽  
The Right ◽  
Special Hospitals ◽  
Reduced Risk ◽  
Psychopathic Disorder

The detention of offenders in the legal category ‘psychopathic disorder’ in special hospitals for treatment raises a number of critical issues. There are doubts about the nature of the disorder; what constitutes treatment; who is ‘treatable’; the effectiveness of treatment; and whether evidence of psychological change implies reduced risk of reoffending. In view of these uncertainties, it is argued that indeterminate hospital orders may provide an unrealistic and unjust legal framework for treating ‘psychopaths' in special hospitals, and the use of powers under the Mental Health Act to transfer such patients to hospital during the course of prison sentences is a more appropriate alternative. This provision could be used more frequently, subject to improved safeguards of the right of release at the expiry of sentence.

scholarly journals What happens to patients discharged by Mental Health Review Tribunals?

1993 ◽  
Vol 17 (6) ◽  
pp. 337-338 ◽  
Author(s):  
Philip Wilkinson ◽  
Michael Sharpe
Keyword(s):  
Mental Health ◽  
Mental Hospital ◽  
Psychiatric Hospitals ◽  
Mental Health Act ◽  
The Right ◽  
Special Hospitals ◽  
Treatment Order ◽  
Health Review

Under the Mental Health Act (1983) Mental Hospital Review Tribunals act as a safeguard against unwarranted detention of patients in psychiatric hospitals. Detention, other than in special hospitals, is most commonly under section 2 (assessment order) or section 3 (treatment order) of the 1983 Act. Patients thus detained have the right to appeal to a Review Tribunal, which has the power to order their discharge.

scholarly journals ‘Psychopaths' in Special Hospitals

1983 ◽  
Vol 7 (10) ◽  
pp. 178-181 ◽  
Author(s):  
David Mawson
Keyword(s):  
Mental Health ◽  
Great Majority ◽  
Prison Sentence ◽  
Mental Health Act ◽  
Special Hospitals ◽  
Psychopathic Disorder ◽  
The Way

The continued existence of ‘psychopathic disorder’ in the Mental Health Act of 1983 ensures that well into the next century individuals thus categorized will be detained in Special Hospitals and elsewhere. In this paper I want to consider the problem of ‘psychopaths' in the Special Hospitals, as I see them, both for the patients and the institutions, and I will pay special attention to the way such patients are detained. More specifically, I will argue that greater use should be made of treatment orders during the course of a prison sentence, rather than at the time of conviction. In other words, let there be more use of Section 72 of the 1959 Act (to become Section 47 of the new Act), as opposed to Sections 60 and 60(65), which in the new Act become Sections 37 and 41 respectively. At the end of 1982 only seven out of about 150 ‘psychopathic disorder’ patients in Broadmoor were detained under Section 72. The great majority were held on Section 60(65).

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>

Preserving Control: Understanding People's Experiences Before, During and After Detention Under the Irish Mental Health Act 2001

2016 ◽  
Vol 33 (S1) ◽  
pp. S483-S483
Author(s):  
D. McGuinness ◽  
A. Higgins ◽  
B. Hallahan ◽  
E. Bainbridge ◽  
C. McDonald ◽  
...  
Keyword(s):  
Mental Health ◽  
Subjective Experience ◽  
Structured Interview ◽  
Legal Framework ◽  
Theoretical Understanding ◽  
Mental Health Act ◽  
Loss Of Autonomy ◽  
Psychiatric Units ◽  
The Face ◽  
Competing Interest

IntroductionThe Mental Health Act 2001 provides a legal framework for the involuntary admission and treatment of individuals deemed to have a mental disorder to psychiatric units. The perspectives of people who have been detained are relatively poorly understood.ObjectiveTo develop a theoretical understanding of individual's experiences throughout the trajectory of their detention and to understand the psychological and social processes that individuals use to cope before, during and after detention.MethodsFifty individuals subject to detention across three psychiatric units consented to be interviewed three months after their detention. Using a semi-structured interview people recounted their experiences. Interviews were analysed using the principles underpinning Grounded Theory.ResultsThe theory ‘Preserving Control’ encapsulates individuals’ experiences and consists of three related themes: ‘Losing Control’, ‘Regaining Control’ and ‘Maintaining Control’. ‘Losing Control’ describes individuals’ experiences of losing their autonomy and liberty thought the process of detention and hospitalisation. ‘Regaining Control describes, the strategies individuals used in an attempted to restore their loss of autonomy and control. ‘Maintaining Control’ describes how individuals lived with the consequences of detention and contended with impact on discharge.ConclusionsWhilst a large variation existed in relation to the subjective experience of being detained, the characteristic process that individuals tend to experience related to identifiable phases of preserving control in the face of this loss of autonomy. Findings from this study highlight the importance of more sensitive interactions support and information during and after the detention process.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals ‘Offenders, Deviants or Patients’ - Comments on Part Two of the White Paper

2014 ◽  
Vol 1 (5) ◽  
pp. 21
Author(s):  
Herschel Prins
Keyword(s):  
Mental Health ◽  
Mental Health Professionals ◽  
Good Deal ◽  
Legal Framework ◽  
White Paper ◽  
Green Paper ◽  
Expert Committee ◽  
The Past ◽  
Mental Health Act ◽  
The Government

<p align="LEFT">The Government White Paper Reforming the Mental Health Act follows closely on the heels of the Green Paper - Reform of the Mental Health Act, 1983 which derives from (but also departs from in many respects) the Report of the Expert Committee chaired by Professor Genevra Richardson. One could say, with some justification, that mental health professionals have been ‘deluged’ with paper in this area in the past year or two, so that trying to discern trends has become very difficult. In particular, the material in the White Paper is somewhat closely written and needs to be read with a good deal of care (or, so it seemed to me). To complicate matters further, offender-patients are also discussed in Part I of the White Paper (The Legal Framework) whereas it would have been more logical to have dealt with the proposed provisions for them in Part II. For clarity, I propose to deal with all these matters under one heading.</p>

scholarly journals Detained patients and the right to refuse treatment

2014 ◽  
pp. 59
Author(s):  
Paul Bowen
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Interested Party ◽  
Mental Health Act ◽  
Human Rights Act ◽  
Human Rights Act 1998 ◽  
Right To Refuse Treatment ◽  
The Right ◽  
Court Of Appeal ◽  
Right To Refuse

<p>R (Wilkinson) v. Broadmoor RMO (1) Mental Health Act Commission (2) Secretary of State for Health (Interested party) [2001] EWCA Civ 1545<br />Court of Appeal (22nd October 2001) Simon Brown LJ, Brooke LJ and Hale LJ</p><p>A detained patient’s right to refuse treatment to which he or she objects has been greatly strengthened by a recent decision of the Court of Appeal, applying the provisions of the Human Rights Act 1998, although in reaching its decision the Court of Appeal has posed as many questions for the future of the law in this area as it has answered.</p>

scholarly journals The mental capacity tribunal under the model law: what are we arguing about?

2014 ◽  
pp. 55
Author(s):  
Robert Robinson
Keyword(s):  
Mental Health ◽  
Psychiatric Treatment ◽  
Dental Health ◽  
Legal Framework ◽  
Mental Illnesses ◽  
Health Law ◽  
Mental Health Law ◽  
Mental Health Act ◽  
Model Law ◽  
Serious Mental Illnesses

It would be a mistake to think of mental health law as a generic form of law directed at a particular class of people, those described as suffering from mental disorders. If a person who has a mental disorder will accept treatment, whether or not they have the capacity to consent to it, there is in general no need to have recourse to mental health law. The Mental Health Act 1983 (‘MHA’) exists for the specific purpose<br />of regulating, and ultimately adjudicating upon, the conflict between a person who objects to receiving psychiatric treatment and the professionals on whom the law confers powers of compulsion. But, as advocates of a capacity-based legal framework would surely agree, it is not the existence of mental health law that gives rise to this conflict. That we have a Mental Health Act but not, say, a Dental Health Act is explained by features characteristic of serious mental illnesses which are not, by and large, found in other medical conditions.

scholarly journals Foreword

2014 ◽  
pp. 4
Author(s):  
Charlotte Emmett
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Legal Framework ◽  
Green Paper ◽  
Health Law ◽  
Special Issue ◽  
Mental Health Act ◽  
Department Of Health ◽  
Review Team ◽  
Key Issues

<p>This special issue of the Journal of Mental Health Law has been prompted by the recent publication of the Government’s Green Paper <em>Review of the Mental Health Act 1983: Proposals for Reform</em>. The Green Paper aims to "modernise the legal framework within which mental health care is delivered" by proposing a number of reforms to the current regime established under the Mental Health Act 1983.</p><p>We have aimed in this edition to highlight some of the key issues arising from both the Green Paper and the Report submitted to the Department of Health by the Scoping Study Review Team, in July 1999.</p>

scholarly journals A new appraisal of Mental Health Review Tribunals

1989 ◽  
Vol 13 (6) ◽  
pp. 299-300 ◽  
Author(s):  
A. T. Grounds
Keyword(s):  
Mental Health ◽  
Psychiatric Patients ◽  
Civil Liberties ◽  
Home Office ◽  
The Public ◽  
Mental Health Act ◽  
European Court ◽  
The Right ◽  
Prime Function ◽  
Health Review

Mental Health Review Tribunals were introduced in the Mental Health Act (1959) to safeguard psychiatric patients against unjustified detention in hospital. The powers of tribunals form “an important part of the fabric of civil liberties” (Wood, 1974). However, in exercising their prime function of preventing unjust detention, tribunals in practice also have to take into account patients' clinical needs and the protection of the public. Further weight was added to this complex burden of decision making following a judgement by the European Court of Human Rights in 1981 which upheld the right of all detained patients to a periodic judicial review of their detention. As a result of this judgement the Mental Health Act (1983) extended tribunal powers to include the release of offender patients sentenced by Crown courts and given hospital orders with restrictions on discharge. Such individuals may have been convicted of grave criminal offences, and their discharge or transfer from hospital would otherwise require the consent of the Home Office.

scholarly journals In relative danger? The outcome of patients discharged by their nearest relative from sections 2 and 3 of the Mental Health Act

2003 ◽  
Vol 27 (02) ◽  
pp. 50-54
Author(s):  
Philip Shaw ◽  
Matthew Hotopf ◽  
Anthony Davies
Keyword(s):  
Mental Health ◽  
Clinical Outcome ◽  
Poor Clinical Outcome ◽  
Retrospective Case ◽  
Mental Health Act ◽  
Mental Health Legislation ◽  
Assessment And Treatment ◽  
The Right ◽  
Health Legislation ◽  
Control Cohort Study

Aims and Method Among the proposed changes in the current review of mental health legislation in England and Wales is the abolition of the right of the nearest relative to discharge patients from assessment and treatment orders (Sections 2 and 3 of the Mental Health Act 1983). We aimed to determine the clinical outcome of patients whose nearest relative applies for discharge. A retrospective case–control cohort study in a south London NHS Trust of 51 patients successfully discharged by their nearest relative and 33 patients whose nearest-relative applications were blocked by the treating psychiatrist on the grounds of ‘dangerousness'. Results Patients discharged from section by their nearest relative did not differ significantly from controls in all the measures of clinical outcome examined. Clinical Implications This study suggests that discharges by the nearest relative against psychiatric advice are not associated with a poor clinical outcome.

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