• The decision process of the mental health review tribunal—2. Analysis of research findings

      Hepworth, David (1983)
      In response to applications, the tribunal should have the power to order delayed discharge by a given date. Improved access to the tribunal should help to safeguard some patients in the future from the dilemmas resulting from unnecessarily prolonged periods of hospital care. Legislation and/or government policy should be changed to require responsible health authorities to provide health care in hospital to enable a resident leave maximum security. The legislation which defines local authority responsibilities to provide residential care should be strengthened to allow their residents to leave security hospital care and the necessary resources made available. A period of statutory after-care (6 months at least) should be a condition of discharge under section 26 or 60. There should be the statutory requirement for local authorities to provide supervision to patients discharged from detention under mental health legislation. Tribunal powers should be extended to include recommendations for transfer or conditional discharge, or trial leave during the period of delayed discharge or adjourned consideration in response to applications. The tribunal authority to require the attendance of witnesses should be strengthened. The position of the patient's respresentative as essential both to the patient and the operation of the tribunal should be acknowledged and strengthened. The tribunal should be required to record the reasons for their decisions, for the information of all parties concerned. The 'judicial' status of the tribunals should be strengthened to gain greater credibility and authority, particularly in respect of patients detained in special hospitals. There should be clear statutory recognition of the continued responsibility of the responsible health authorities while their residents are in special hospitals, this joint responsibility to be reflected in the working relations between the health authorities and special hospitals. Closer and more effective working relations between special hospitals and health and social services should be promoted by greater 'regionalization' of the special hospital service. Special hospitals should be sanctioned to provide facilities for short-term 'informal' rehabilitative care in cooperation with health and community services.
    • The decision process of the mental health review tribunal—I. Review of literature and research

      Hepworth, David (1983)
      The aims and intentions of this analysis are: To review the literature and previous research about the mental health review tribunals from the time they were established by the Mental Health Act 1959 and commenced operation in 1961; and to consider the findings of this particular research project on the decision-process of the mental health review tribunal with reference to the previous literature and research.
    • Fitness to plead and psychiatric reports

      Larkin, Emmet P.; Collins, P. J. (1989)
      The role of the psychiatrist in the determination of fitness to plead is reviewed by reference to 77 pre-trial psychiatric reports prepared on 31 Special Hospital patients detained under the provision of Section 5(1)(c) (Unfit to Plead) of the Criminal Procedure (Insanity) Act 1964. Each psychiatric report was analysed using a standardized checklist which addressed the legal criteria used to determine fitness to plead, the nature of the alleged offence and the clinical diagnosis. The results showed that almost 40% of the reports made no mention of fitness to plead at all and that only one-third of the reports made a statement about fitness to plead which was supported by reference to standard legal criteria. The results of this study support earlier work which has suggested that psychiatrists have a poor understanding of the issues surrounding fitness to plead and criminal responsibility. These findings are discussed in relation to recommendations made by the Report of the Committee on Mentally Abnormal Offenders, 1975 (Butler Report) and legislative changes introduced by the Mental Health Act 1983.
    • Section 25 aftercare under supervision: The first eighteen months' experience

      Davies, Steffan (1999)
      Supervised discharge was introduced, against much professional opposition, in the Mental Health (Patients in the Community) Act 1995. All patients subject to supervised discharge (SD) in a large health district were identified by medical records departments, and the outcome of their SD on 1 October 1997, eighteen months after the legislation came into effect, was assessed. In that first eighteen months, half of the general, rehabilitation and forensic psychiatrists in the trust used SD for 22 patients. Of the 12 orders in effect for over six months, six were renewed at six months and three at one year. In spite of professional hostility and scepticism about the clinical practicalities of SD, the use of the new power has gradually increased with experience. Outcomes to date seem generally positive, but further definitive research is needed.
    • Criminal law and mentally ill offenders in comparative perspective

      Koenraadt, Frans (2000)
      In this article we compare legal arrangements dealing with mentally disordered offenders in the criminal law systems of Belgium, Canada, Germany, the Netherlands, Norway, Sweden, and the United Kingdom. To describe relevant differences and similarities in the arrangements, we used a checklist containing central aspects of adjudication, assessment and treatment of mentally ill offenders. These aspects concern: (1) the legal classifications of mental illnesses that can lead to exclusion of criminal responsibility; (2) the acceptance of diminished capacity as a partial excuse; (3) the possibilities for imposing security measures of compulsory treatment instead of or next to criminal punishment; (4) the conditions for their imposition in terms of seriousness of crimes committed and dangerousness of offenders; (5) the available hospitals or special clinics for executing security measures; (6) the role and task of forensic mental health professionals in assessing the offender's state of mind and in advising compulsory treatment; (7) the rules for duration, prolongation and termination of the measures. The findings of this comparative analysis are evaluated in light of legal protection for mentally disordered offenders.
    • A bail and probation hostel for mentally disordered defendants

      Geelan, Steve (2000)
      Elliott House is the only specialized approved bail and probation hostel for mentally disordered men in the UK. It was established as a partnership between the West Midlands probation service and the forensic psychiatry services based at the Reaside Clinic. We report on the evaluation of this facility. Comprehensive social and psychiatric data were collected on all those residents between August 1994 and April 1996. The reason for leaving the hostel was also recorded. During the study period, 83 men completed a period of residence. Of these men, 47% had a psychotic illness. Deliberate self-harm was a significant problem in 13%. Only 4% reoffended whilst resident at the hostel. The condition of residency was breached by 41%. Departure was a result of a normal bail variation for 22% and of admission to hospital for 11%. Elliott House is a successful national resource, attracting residents with major mental disorders. A key principle of the recent White Paper is that the NHS will work in partnership with other agencies to put the needs of patients at the centre of the care process. The hostel demonstrates that a close partnership between separately managed agencies can successfully deliver care to a previously deprived group.
    • Ethical issues

      Robertson, John P. (2001)
    • Probation orders with conditions of psychiatric treatment: A descriptive study

      McInnes, Robert; Davies, Steffan (2003)
      Although probation orders with conditions for psychiatric treatment (POPTs) have been in existence for many years there is very little literature relating to their use and almost none from a psychiatric perspective. All patients who were subject to, or had recently completed, a POPT in Leicestershire were identified and information on them collected from psychiatric and probation records. Of 33 POPTs identified, psychiatric information was found for 31 and probation for 23. The most striking feature of the sample was its great heterogeneity in terms of psychiatric diagnoses and index offences. Worryingly, a number of serious offences did not lead to charges or convictions and there was evidence of poor communication between and within agencies, particularly psychiatric services. Our recommendations for improvement mirror those of other studies in the area, namely, better training of the staff from the multiple agencies involved, improved communication, better documentation and ongoing Audit to prevent the situation continuing.
    • Editor's introduction to the special issue

      Hollin, Clive R. (2004)
      In this Special Issue, Professor Ward and Eccleston have assembled a formidable cast of contributors who can take the hard questions full on, asking a few of their own as they go. It is my view that the level of debate set up by this collection of papers is absolutely critical to the further development of the field. I took a great deal from reading these papers and I am confident that others will too. The work that goes into editing a collection of papers such as this should not be underestimated and we owe a debt of gratitude to the Guest Editors for all the work they have done in bringing together this edition. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Editorial: Introduction to special edition on law and rights, International Journal of Law and Psychiatry

      Bartlett, Peter (2005)
      This editorial presents an introduction to the special edition on law and rights. Much of the legal debate and development regarding mental health and rights in the last 15 years or so has sprung from international human rights instruments. Whether this involves instruments directed specifically at mental disorder, or the application of more general human rights instruments, national compliance with international obligations has acquired a central place in legal debates surrounding mental health law. It is a theme which permeates the papers in this volume. At its most theoretically simple level, discussions of this compliance must be based on some systematic assessment of whether the state in question is in compliance with its obligations: a rights audit is required. One of the papers in this volume provides a framework for such an audit, based on the obligations contained in the United Nations Principles. The majority of the papers note the increasing importance of capacity in modern understanding of mental health law, but there is no express reference to this concept in the key general international human rights documents. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • The Children Act: Key points and implications for nursing

      Luce, Rosie (2005)
      This article sets out the key points of the Children Act 2004 and considers the implications for practice, with particular regard to the patient assessment process and the links between adult behaviour and child protection.;
    • Whose right?

      Masterson, Stephen (2006)
      Background: Mental health practice has become an archetypal arena in which the political philosophical tensions between the rights of the individual and the rights of the community are played out. In the UK, controversy surrounds the proposed mental health bill and it brings to the fore classic debates regarding rights in respect of care versus control and the legitimacy of coercion. Aim: This paper interrogates New Labour's proposed mental health legislation. Method: Using classic political theoretical debates on rights this paper interrogates the internal consistency and thus the implications of New Labour's proposed mental health legislation for both service users and practitioners. Results: The paper finds that in their current form not only does legislation threaten the state's previous commitment to a positive conception of liberty for service users, but that proposed legislation will seriously compromise the more basic negative liberty, the right to non interference and autonomy. It is argued that the new mental health bill makes possible enforced treatment without the safeguard that it must be of therapeutic benefit. Conclusion: Policy must enshrine a clear human rights agenda, not only for the benefit of service users, but also to provide effective guidance and professional protection to those practitioners responsible for care in the community. © Shadowfax Publishing and Taylor & Francis.
    • Changes to (un)fitness to plead and insanity proceedings

      Morris, Adrian; Elcock, Sue; Hardie, Timothy (2006)
      Significant changes to both unfitness to plead and the defence of insanity are hidden away in the Domestic Violence, Crime, and Victims Act 2004. These changes, which could easily be overlooked, are the subject of discussion in this paper. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • Social circumstances reports presented to mental health review tribunals

      Lewis, Keith T. (2006)
      This paper describes the social circumstances report, written for the MHRT in an historical setting, and incorporates a small-scale audit to determine the effect of implementing national guidelines in July 2002. Sixty reports were audited - thirty in the period immediately before the introduction of national guidelines, and thirty immediately following the introduction of national guidelines. These reports concerned only patients subject to a hospital order with restriction under Section 37/41 of the Mental Health Act of 1983. National guidelines comprised 102 individual sub-headings within 17 main headings. Each report was scored using these guidelines as a checklist. Results show that compliance as measured by the national guidelines significantly improved following their circulation. Very little previous research has been undertaken in this area and only by researchers from the legal profession. Further research may need to be undertaken by social work professionals themselves, and by local authorities, which may encourage others in the profession to build on this knowledge. At present the process appears to be exclusively a legal interest rather than a joint interest with social care. (PsycINFO Database Record (c) 2016 APA, all rights reserved)
    • The Mental Health Act, approved clinician and supervised community treatment orders

      Diamond, Bob (2007)
      The paper considers the context of the amendments to the Mental Health Act and the implications for clinical and forensic psychologists as approved clinicians. The following concerns are raised: 1. The draft Mental Health Bill was more concerned with protecting public safety rather than providing legislature for mental health and well-being. 2. The approved clinician role compromises clinical and forensic psychologists on two accounts: the roles of therapist, advocate and ally are undermined by those of law enforcer and custodian; the approved clinician role will remain subservient to psychiatry, the dominant discourse in mental health services. Psychologists hands will be clinically tied. The implications of these developments place the professions of clinical and forensic psychologists at an irrevocable turning point causing irreparable damage to the respective professions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(journal abstract)
    • Mental disability and the European Convention on Human Rights

      Bartlett, Peter (2007)
      Mental disability has come of age as a subject of concern under the European Convention on Human Rights. It was only in 1979 that the first significant decision of the ECHR was decided on the subject, and after that, cases were relatively few for many years. It is only recently that this has begun to change. This volume provides an account of where the law currently stands and speculation as to how it may develop. The initial chapters deal with substantive aspects of Convention rights (including issues of detention in institutions, conditions within institutions, medical treatment, problems associated with guardianship and others). The final two chapters move to discuss the practicalities of litigation. The book concludes with a number of appendices (primarily the primary international legal materials of relevance to mental disability rights under the ECHR, and the relevant recommendations and principles from the Council of Europe). It is hope that this volume, in addition to shedding light on where the law currently stands, will offer practical guidance to lawyers concerning the mechanics of representing people with mental disabilities.
    • Can we harmonise forensic psychiatry across Europe?

      Khalifa, Najat; Taylor, Mark H. (2008)
      Comments on an article by H. Gordon and P. Lindqvist (see record 2007-17844-006). The authors refer to harmonisation of forensic psychiatry in Europe. We agree with the authors that, although laudable in principle, such undertaking is difficult, if not impossible, to achieve. However, it is possible to share experiences and learn from each other. In the section on ethics in forensic psychiatry the authors call attention to reports of differences in the canons of ethics pertaining to US and British forensic psychiatrists. The fact is that one or two prominent US forensic psychiatrists visiting the UK have misinformed our British colleagues that forensic psychiatrists in the USA follow principles of ethics that are different from the code of medical ethics applicable to psychiatrists everywhere. (PsycINFO Database Record (c) 2016 APA, all rights reserved)