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Essay 19: Mental Health Act

9 posts in this topic

Review New Mental Health Act.Critically appraise it in relation to clinical practice.

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THE NEW MENTAL HEALTH ACT

INTRODUCTION

The Draft Mental Health Bill  was passed in June 2002. It has raised a lot of questions about the future use of the Mental Health Act to detain people just to protect the public.

CONTENT  

MHA of 1983: Under this act  4 conditions should be satisfied before any compulsory powers can be used:

there must be a mental disorder

this must be of a nature or degree warranting medical treatment

treatment must be necessary for the health or safety of the patient or the protection of others and

must need an inpatient setting for appropriate treatment

Under the proposed act The broad definition of mental disorder not only means that dangerous people with severe personality disorder would be included, but it also raises the possibility of compulsory treatment for sexual deviancy and dependence on alcohol or drugs.

The proposed act  is a wide net that is particularly likely to ensnare people who present a danger to others and does create opportunities for preventive detention.

The 'treatability test,' which has been used to exclude some patients with psychopathic disorder and mental impairment from treatment under the current act, is also conspicuous by its absence. It removes the treatability element from the old act, creating the very real possibility that someone who continues to pose a risk to the public due to their personality, rather than their psychiatric illness, could be detained indefinitely.

This raises a whole host of issues, which seem to impinge on someone's civil rights. Does the state have the power to detain someone forever?

What should be held uppermost, the individual's civil rights, or those of the state? Are we now in fact punishing someone for developing a mental illness? What does this say about us as a civilized society?

ON THE OTHER HAND THERE ARE DISTINCT ADVANTAGES

These include:

The New Mental Health act is probably more advantageous in the High Secure Setting, providing more robust powers of scrutiny and detainment of dangerous mentally ill offenders in relation to Restriction Orders.

The new provision of the Clinical Supervisor and the Approved Clinician, which have differing roles, may be advantageous. The role of the Approved Clinician is not automatically applied to that of the Psychiatric Consultant. This may free the Psychiatrist from the time consuming coordinating role currently held by the Responsible Medical Officer status and a return to true consultation and therapeutic practice.

Sharing information to improve patient care provisions within the Bill would impose a general duty to co-operate in the supply of information in relation to risk management and assessment and for protocols to be developed between agencies carrying out statutory functions within the Act.

This would enable easier access to other sources of information that are maybe sometimes difficult to obtain currently such as those of independent assessments. It will also remove some of the current ethical dilemmas and difficulties related to patient confidentiality in relation to matters of risk.

The proposed provision of the compulsory treatment within prisons provided by NHS staff is a welcome initiative, as it would lead to an improvement of the services for the prisoners.

CONCLUSION:

The difficult issue of how we can manage a civilized society and both protect the rights of society and the human rights of those who live within it, is perhaps one which will continue to be a problem for many years to come

Do we therefore have the right to treat someone for a condition that is not necessarily ego-dystonic? It seems more clear that we, as health professionals, are being asked to 'treat' antisocial personality disorder in order that the public are 'safer' If there is no clear treatment for this condition, where does that leave psychiatry? Many would also argue that if the state wants to remove these people from society, then the state should accept responsibility and use the criminal justice system to achieve its aims

Perhaps then it is a review of the criminal justice legislation that is in need of review, rather than the mental health legislation

REFERENCES:

BMJ 2001;322:2-3

Editorials

A new mental health (and public protection) act

Chris Simpson

Commissioning mental health services: role of the consultant psychiatrist

Advan. Psychiatr. Treat., Jan 2000; 6: 73 - 80.

JOANNA MONCRIEFF

The politics of a new Mental Health Act

Br. J. Psychiatry, Jul 2003; 183: 8 - 9.

The Human Rights Act and mental health legislation

Br. J. Psychiatry, Feb 2003; 182: 91 - 94.

ADRIAN GROUNDS

Reforming the Mental Health Act

Br. J. Psychiatry, Nov 2001; 179: 387 - 389.

Chip in with your bits now ..........!!        :) ::):o :-* :-*

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there will not be an essay asking specifically about the proposals for a mental health act for england and wales, as the college exam is not specifically about practice in england and wales - lots of candidates from scotland, ireland and overseas.

there may be a question about mental health law in general, but if answered with sole reference to the proposed new act then i don't think it would get good marks.

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Dear Johnniespring

Thanx for ur kind advice.

It makes sense. :o ::):P :P

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Dear All,

I understand from lots of people who passed the exam that THERE IS NO NEED TO READ any journals for passing the essay.

what needs to be learnt is the CORRECT way to write like introduction, arguement for and against & conclusions!!

whatever knowledge WE ALREADY HAVE IS ENOUGH TO PASS!!!

we just need to use our common sense & ask ourselves WHY WHEN WHERE WHAT WHO & HOW for each essay!!

I know this is very controversial & i am sticking my neck out but a discussion would be of immense help!!!

come on guys start loading your guns!!! :-/ :-/

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I agree with Adil - technique probably counts for a lot.

Probably good however to be acquainted with a few of the model answers issued by courses such as the Manchester course - other than that I can't see any point in reading journal articles in preparation for the essay paper - looking back over the last few years on this site, you will find that the predictions based on journal articles are very imprecise.

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I mostly agree. Without good essay writing skills, the College are more likely to subtract marks and I know one very well read colleague who failed on poor technique despite loads of refs.

I'm sure someone mentioned on this site that there is a token mark awarded for citing references. I got together a few dozen key references (took no time) and was able to back up my reasoning using these. Looks slick too. I try to get as many marks as i can using as minimal effort as I can and really think it is time well spent.

Elvis ;)

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Looking at the answer to Essay 19 i was wondering if, in the exam, references need to be quoted at the end of the essay. I mean, like the person who has posted the answer, in this instance, has done. Or like a normal textbook or journal article would do, by listing references in the end.

My understanding was that references had to be thrown in the body of the essay, just like any paragraph of text would do.

Please, could someone clarify.

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zonk,

there is no set pattern for writing references.it can be done either way.if you are very certain about the referees and have a few in hand,writing then to the end shows your confidence but you are leaving yourself open to scrutiny easily.

if the referees are mingled in the body of the essay,the examiner may feel that he read some references but will not remember them.Pros and Cons i suppose!! well this was what an examiner who is working in our trust said.so i believe him!! good luck

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