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'.
Patients discharged from section by their nearest relative did not differ significantly from controls in all the measures of clinical outcome examined.
This study suggests that discharges by the nearest relative against psychiatric advice are not associated with a poor clinical outcome.
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