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Compulsion under the Mental Health Act 1983: audit of the quality of medical recommendations

  • Julian Mason (a1), Hannah Roberts (a2), Rebecca Northridge (a2), Garyfallia Fountoulaki (a1), Emma Andrews (a3), Cassie Watcyn-Jones (a1), Terri Manion (a2), Julie Chalmers (a2) and Phil Davison (a2)...
Abstract
Aims and method

To audit the quality of medical recommendations for detention under the Mental Health Act 1983, Section 2 and 3. The recommendations were tested against a gold standard based on the statutory criteria. Two cycles were completed, the first containing 214 recommendations, the second 202. Relevant education took place after the first cycle.

Results

The percentage of medical recommendations containing clear statements of why each of the statutory criteria was met increased in the second cycle. It reached 87% for mental disorder; 87% for nature and/or degree; 75% for why community treatment was not possible; 64% for why detention was in the interests of health; 60% for safety; 55% for protection of others; and 70% why informal admission was not possible.

Clinical implications

Doctors, scrutineers and approved mental health practitioners welcomed clear guidance about what is expected in a medical recommendation for detention and endorsed the gold standard described. Armed with a better understanding of what is expected and a template to follow, there was an improvement in the reasons given for detention.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Julian Mason (jules.mason@berkshire.nhs.uk)
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Declaration of interest

None.

Footnotes
References
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1 Mental Health Act Commission. The threshold for use of the 1983 Act. In 10th Biennial Report, 2001–2003: Placed Among Strangers: 87116. TSO (The Stationery Office), 2003.
2 Fennell, P. Section 12 approved doctors. In Mental Health: The New Law (Jordans' New Law Series): 72. Jordans, 2007.
3 Bartlett, P, Sandland, R. The writ of habeas corpus in the medical recommendations in the process of civil confinement. In Mental Health Law Policy and Practice: 187–90. Oxford University Press, 2007.
4 Jones, RM. General provisions as to medical recommendations. In Mental Health Act Manual: 8793. Thomson, Sweet and Maxwell, 2008.
5 Zigmond, T. A new Mental Health Act for England and Wales: grounds for compulsion. Adv Psychiatr Treat 2004; 10: 243–6.
6 Fennell, P. Defining mental disorder in mental health: the new law. In Mental Health: The New Law (Jordans' New Law Series): 17–9. Jordans, 2007.
7 Mental Health Act Commission. R (on the application of the secretary of state for the Home Department) v MHRT and (1) DH (2) South West London & St George's Mental Health NHS Trust. Quoted and discussed in The Mental Health Act in the courts. In The Eleventh Biennial Report 2003–2005: In Place of Fear? TSO (The Stationery Office), 2006: 91.
8 Department of Health. Application for detention in hospital. In Code of Practice Mental Health Act 1983: 2450. TSO (The Stationery Office), 2008.
9 Fennell, P. Necessary in the interests of the patients' health or safety or for the protection of others and the treatment cannot be provided unless he is detained under this section. In Mental Health: The New Law (Jordans' New Law Series): 153. Jordans, 2007.
10 Fennell, P. Mental disorder of a kind or degree warranting confinement. In Mental Health: The New Law (Jordans' New Law Series): 66–7. Jordans, 2007.
11 Fennell, P. Replacing treatability with availability of appropriate treatment. In Mental Health: The New Law (Jordans' New Law Series): 67–9. Jordans, 2007.
12 Bartlett, P, Sandland, R. The medical recommendations. In Mental Health Law: Policy and Practice: 174–7. Oxford University Press, 2007.
13 Mental Health Act Commission. The interface between the Mental Capacity and Mental Health Act. In The Eleventh Biennial Report 2003–2005: In Place of Fear?: 176–80. TSO (The Stationery Office), 2006.
14 Fennell, P. Medical recommendations and section 12 approved doctors. In Mental Health: The New Law (Jordans' New Law Series): 84–7. Jordans, 2007.
15 Bartlett, P, Sandland, R. Scrutiny and rectification of documentation on arrival at hospital in the process of civil confinement. In Mental Health Law: Policy and Practice: 183–5. Oxford University Press, 2007.
16 Department of Health. Receipt and scrutiny of documents. In Mental Health Act Code of Practice: 103–6. TSO (The Stationery Office), 2008.
17 Keywood, K. Rectification of incorrect documentation under the Mental Health Act 1983. J Forens Psychiatry 1996; 7: 7981.
18 Jones, RM. Rectification of applications and recommendations. In Mental Health Act Manual: 8793. Thomson, Sweet & Maxwell, 2008.
19 Eastman, N, Peay, J. Bournewood: an indefensible gap in mental health law. BMJ 1999; 317: 94–5.
20 Fennell, P. Patients who lack capacity to consent to treatment or admission. In Mental Health: The New Law (Jordans' New Law Series): 122. Jordans, 2007.
21 Wall, S, Churchill, R, Hotopf, M. A Systematic Review of Research Relating to the Mental Health Act 1983. Department of Health, 1999.
22 Bhatti, V, Kenney-Herbert, JP, Cope, RV. Knowledge of Current Mental Health legislation among medical practitioners approved under section 12(2) of the mental health act 1983 in the West Midlands. Health Trends 1999; 30: 106–8.
23 Peay, J, Roberts, C, Eastman, N. Knowledge of mental health law of practitioners and responsibilities under the Mental Health Act (1983): a national survey. J Ment Health Law 2001; 1: 44–5.
24 Peay, J, Roberts, C, Eastman, N. Mental health professionals' attitudes towards legal compulsion: report of a national survey. Int J Forens Ment Health 2002; 1: 7182.
25 Humphreys, MS, Kenney-Herbert, JP, Cope, RV. How to keep up with the Mental Health Act. Adv Psychiatr Treat 2000; 6: 407–11.
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Compulsion under the Mental Health Act 1983: audit of the quality of medical recommendations

  • Julian Mason (a1), Hannah Roberts (a2), Rebecca Northridge (a2), Garyfallia Fountoulaki (a1), Emma Andrews (a3), Cassie Watcyn-Jones (a1), Terri Manion (a2), Julie Chalmers (a2) and Phil Davison (a2)...
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