scholarly journals Ethics and Section 58 of the Mental Health Act (1983)

1993 ◽  
Vol 17 (8) ◽  
pp. 481-483
Author(s):  
Femi Oyebode
Keyword(s):  
Mental Health ◽  
Drug Treatment ◽  
Medical Officer ◽  
Present Form ◽  
British National Formulary ◽  
National Formulary ◽  
Code Of Practice ◽  
Mental Health Act ◽  
Consent To Treatment

Section 58 is in the part (Part IV) of the Act which is largely concerned with consent to treatment by patients detained on Sections 2, 3, or 37 of the Mental Health Act (1983). It applies to drug treatment if three months or more have elapsed since drugs were first given during the period of detention. It also applies to ECT at any time during the period of detention. Where a patient consents to treatment which comes under Section 58, and which the responsible medical officer (RMO) has proposed and explained to the patient, the RMO is required to certify in writing, on Form 38, that the patient is capable of understanding the nature, purpose and likely effect of the treatment and that the patient has consented (DOH, 1987). The Code of Practice (DOH, 1990) advises that the RMO should indicate on the certificate the drugs proposed, by the classes described in the British National Formulary (BNF), indicating the dosages if they are above BNF advisory maximum limits. The method of administration should also be indicated. This paper will argue that Section 58 in its present form does not strengthen the patient's right to consent to treatment and that the form of words advised in the Code of Practice with respect to Form 38 is faulty in conception.

Consent to Treatment, Second Opinion Appointed Doctors and Code Compliance - an Audit?

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Qureshi ◽  
G. Kirk
Keyword(s):  
Mental Health ◽  
Treatment Plan ◽  
Medical Officer ◽  
Second Opinion ◽  
Care Plan ◽  
Code Of Practice ◽  
Mental Health Act ◽  
Legal Perspective ◽  
Wide Range ◽  
Consent To Treatment

Aim:Ensuring standards of section 58 documentation and associated communication complies with the code of practice of the Mental Health Act 1983 UK.Method:Case note review of detained patients under section 3 of Mental Health Act (MHA) 1983, requiring either a certificate of consent to treatment (form 38) or a certificate of second opinion authorising treatment (form 39), beyond first three months of medication. A standard checklist was devised, based on recommendations of MHA commission and code of practice.Results:Form 38 (5 Patients), 100% completion of names, dosage, route of adminstration of medication and proposed number of ECT treatments. Only 60% completion of documentation regarding treatment plan explanation and stating whether clozapine was included excluded.Form 39 (7 patients) completed correctly in 100% cases with recommendation by second opinion appointed doctor (SOAD) in 85% cases. No documentation by SOAD in case notes and contact with the responsible medical officer (RMO) was only by phone (should have face to face contact). Only in 28% of cases RMO documented the SOAD visit and outcome.Conclusion:This audit has highlighted wide range of implications from the medico-legal perspective. The statutory documents, form 38 and 39, were completed correctly in majority of cases except for minor omissions. Adequate documentation was lacking with regards to discussion about the care plan and outcome of the SOAD visit. SOAD contact with the RMO was only on the phone (should only be in emergency) and no documentation of the second opinion in the case notes apart from filling the form 39.

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.

scholarly journals Consent to Treatment: Legal and Ethical Aspects

1981 ◽  
Vol 5 (11) ◽  
pp. 207-209
Author(s):  
Paul Bowden
Keyword(s):  
Mental Health ◽  
Public Policy ◽  
Mental Disorder ◽  
Medical Officer ◽  
Working Party ◽  
Ethical Aspects ◽  
Mental Health Act ◽  
Consent To Treatment ◽  
Patient’S Will ◽  
Policy Committee

In anticipating the consultative paper A Review of the Mental Health Act, 1959 the College's Public Policy Committee prepared a report in 1974 (News and Notes, October, November 1974). The second of six points covered in the report related to compulsory detention and treatment. It reads:The Working Party are firmly of the view that compulsory powers should include the power to treat patients compulsorily for any form of mental disorder, but has doubts as to how far certain types of treatment should be applied on the sole authority of the Responsible Medical Officer against the patient's will or when he is incapable of giving consent.

scholarly journals An audit on consent to treatment within forensic inpatient units at the Newsam Centre

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S9-S9
Author(s):  
Elisabeth Bond ◽  
Stephanie Vel En Tial ◽  
Clare Stephenson
Keyword(s):  
Mental Health ◽  
Easy Access ◽  
Microsoft Excel ◽  
Team Meetings ◽  
Code Of Practice ◽  
Mental Health Act ◽  
Consent To Treatment ◽  
Age Range ◽  
Inpatient Units ◽  
Audit Standards

AimsWe aimed to investigate the adherence to the Mental Health Act Code of Practice and the adequate documentation of consent to treatment across three forensic low secure inpatient units.MethodOur sample included all inpatients detained on three forensic wards at The Newsam Centre. This included a total of 31 patients with an age range of 25 to 59 years. The Mental Health Act Code of Practice was used as criteria for audit standards. Data were collected using Microsoft Excel and analysed using descriptive methods.ResultWe found that 28 patients out of 31 had been admitted for over three months and of these patients 12 were subject to a T2 and 16 subject to a T3. A total of 24 patients had their CTT medication list documented on the online drug chart; with a remaining seven patients who did not. As per guidelines, 27 patients had the appropriate medications prescribed as per their CTT, however one patient did not. The audit revealed a total of two patients currently on a Section 62. Of the qualifying T3 forms, four patients had this reviewed every two years whilst there was one patient who had not.ConclusionWe found that the adherence to Mental Health Act Code of Practice was overall positive with the majority of service users being reviewed appropriately and documented as per guidance. However, areas identified for improvement included the recording of CTT on online drug charts as well as reviewing T3 every two years. This audit highlights the need for easy access to guidance, appropriate documentation as well as frequent checking of adherence. A leaflet has been created outlining the guidelines and will be distributed to all staff working within the forensic settings and placed in easily accessible locations. As further recommendations from this audit we advise all wards to plan weekly checks during team meetings to ensure information is up to date and that all staff are aware of any discrepencies. A re-audit is planned in the coming months to re-assess adherance after implementation of the interventions.

scholarly journals Consent to treatment and clinical decision analysis

1989 ◽  
Vol 13 (2) ◽  
pp. 79-81 ◽  
Author(s):  
Ernest P. Worrall
Keyword(s):  
Mental Health ◽  
Drug Treatment ◽  
Decision Analysis ◽  
Medical Practice ◽  
Clinical Decision ◽  
Second Opinion ◽  
England And Wales ◽  
Mental Health Act ◽  
Consent To Treatment ◽  
First Time

The 1984 Scottish Mental Health Act (and its counterpart in England and Wales) invoked unique restrictions in medical practice in this country. For the first time certain standard treatments could not be given to particular patients unless an independent second opinion doctor authorised that treatment. Fortunately, in respect of drug treatment and ECT the second opinion doctors are themselves practising clinicians. Second opinion doctors are asked to give their opinion about the suitability of a proposed treatment using the following guidelines: “the appointed doctor will have in mind his/her understanding of practice accepted as proper by a responsible body of medical men skilled in this particular art in Scotland at this time and should avoid any idiosyncratic view of treatment however firmly held”.

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).

scholarly journals The Mental Health Act 1983 Draft Code of Practice

1987 ◽  
Vol 11 (2) ◽  
pp. 63-67
Keyword(s):  
Mental Health ◽  
Medical Association ◽  
British Medical Association ◽  
Draft Code ◽  
Code Of Practice ◽  
Mental Health Act ◽  
Medical Defence

It was felt that Members of the College would be interested to see the comments of the British Medical Association and the Joint Co-ordinating Committee (The Medical Protection Society, The Medical and Dental Defence Union of Scotland and the Medical Defence Union) on the Mental Health Act 1983 Draft Code of Practice. The comments of the College were published in the Bulletin, August 1986, 10, 194–195.

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.

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