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markone_8

Mental Health Review Tribunals, standing in

11 posts in this topic

How do others feel about standing in at MHRT's when the RMO is absent?

This happened to me yesterday when the consultant from another team was away. The first time I met the patient was just before the tribunal. I had time to review the notes and the report. I'd been asked to do it late on Friday. The tribunal was on a Tuesday following a bank holiday.

The whole thing was most unsatisfactory. My interview with the patient had not revealed any symptoms of mental illness. I could not answer why he was on haloperidol despite having suffered a dystonic reaction. I had to state it would not have been my drug of preference. I also had to state I had no prior knowledge of the patient and explain why I was there!

Perhaps the RMO's report would have sufficed in this instance.

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everyone says it is good experience...

how did it feel? honestly?

what was the outcome?

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It felt painful. I wasn't justifying my own decisions though.

Outcome - kept on Section.

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I agree with Elton Road that it is most unsatisfactory.

I think one of my previous consultants made a lot of sense when he said, &quot:lol:o not go to a tribunal if you are not in agreement with, and prepared to defend, the decision to detain the patient.'  In such a situation as an SpR, perhaps it may be appropriate to say this to the consultant covering for that team.  One option may be to do a report but to make it clear in the impression/plan/recommendations bit, that this is the plan of the consultant appearing before the tribunal.

I was asked, on my first day as SpR in a new team, to do a tribunal report that day and appear for the tribunal the next day (my team consultant being away).  I must say I agreed, feeling under pressure as it was my consultant's patient.  Having heard the history and examined the patient, I was more than happy to go to the tribunal.  The patient stayed on the section.

As an aside, there are some cases I've heard of, where the consultants go to the tribunal hoping that the tribunal will discharge the patient.  In such cases, they may be deliberately ambivalent about the necessity to detain the patient.  This may be the case with detentions involving personality-disordered patients.  I wonder if others have come across this sort of situation.

Addy.

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Outcome - kept on Section.

If you couldn't find any signs of mental illness (and presumably the tribunal didn't see any), why the above outcome? Was the RMO's report so convincing?

I've only been in one- I knew the patient, but it was still horrible. I hate justifying others' decisions, not to mention the patient associates you with the tribunal's decision, so it is your therapeutic relationship that gets screwed up....

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If you couldn't find any signs of mental illness (and presumably the tribunal didn't see any), why the above outcome? Was the RMO's report so convincing?

The history was good enough to keep him on Section. There were plenty of symptoms prior to admission and a long history of drug misuse. He had also behaved oddly on the ward, just not in my interview.

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I bet the MHRT rarely go against the RMO decisions - rather like the SOAD!

Audit someone!

Wish someone had told me that the best way to maintain the therapeutic relationship was to focus on the positive while getting across the first rank symptoms :

e.g 'Although Mr. X harbours homicidal feelings towards Y and Z who he believes are posioning him he participates actively in the ward groups and is abstaining from cannabis use as he recognises its role in his belief system'.

I also think we should all have mental health law as part of our training.

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e.g 'Although Mr. X harbours homicidal feelings towards Y and Z who he believes are posioning him he participates actively in the ward groups and is abstaining from cannabis use as he recognises its role in his belief system'.

:lol: :lol: :lol: 8-)

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Doing it for another team when then consultant is away is bad practice. That would not happen where I work. You should go into a tribual knowing the report and your patient inside out, as you are there as a professional witness to state the facts. Not good!

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I sat in the tribunal last tuesday . But my experience was slightly different. My consultant was away the previous week and came in on that day ( the patient was on section 2 and hence the tribunal was arranged in short notice). I had prepared the report and interviewed the patient. My consultant asked me to give the medical evidence in tribunal. It was nice as I knew she would jump in if I was making any blunders. At the end she gave me good feedback on what I did well and where I needed to improve. This improved my confidence especially considering the fact that I am in the first few weeks of my registrar training.

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all symptoms tell you is degree. they tell you nothing about nature. the tribunal will not discharge a homeless man with a risky history for example just because he is not symptomatic

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