Skip to main content
×
×
Home

Knowledge of mental health legislation in junior doctors training in psychiatry

  • Ovais Wadoo (a1), Aadil Jan Shah (a1), Nadarajah Jehaanandan (a1), Michelle Laing (a2), Manoj Agarwal (a1) and Peter Kinderman (a3)...
Abstract
Aims and method

To assess junior doctors' knowledge of the procedures involved in involuntary admission of patients detained under Sections 5(2), 2 and 3 of the Mental Health Act 1983. A semi-quantitative research study of junior trainees affiliated to two psychiatry training schemes was carried out.

Results

Trainees' knowledge of professionally relevant sections of the Mental Health Act was patchy. Knowledge correlated significantly with experience in clinical practice and with experience of using mental health legislation. Surprisingly, in-service training in mental health legislation had no effect on participants' knowledge.

Clinical implications

Lack of knowledge and understanding raises the possibility of inappropriate use of the mental health legislation. This threatens patients' fundamental rights and can lead to complaints or litigation. There is a clear need to address this at an early stage in psychiatry training.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Knowledge of mental health legislation in junior doctors training in psychiatry
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Knowledge of mental health legislation in junior doctors training in psychiatry
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Knowledge of mental health legislation in junior doctors training in psychiatry
      Available formats
      ×
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
Ovais Wadoo (owadoo@nhs.net)
Footnotes
Hide All

See commentary, pp. 466–468, this issue.

Declaration of interest

None.

Footnotes
References
Hide All
1 Eastman, N. Mental health law: civil liberties and the principle of reciprocity. BMJ 1994; 308: 43–5.
2 Caldicott, F, Mann, S. Mental health law. BMJ 1994; 308: 408–9.
3 Humphreys, MS, Ryman, A. Knowledge of emergency compulsory detention procedures among general practitioners in Edinburgh. BMJ 1996; 312: 162–3.
4 Humphreys, MS. Non-consultant psychiatrists' knowledge of emergency detention procedures in Scotland. A national survey. Psychiatr Bull 1997; 21: 631–5.
5 Humphreys, MS. Consultant psychiatrists' knowledge of emergency detention procedures in Scotland. Med Sci Law 1998; 38: 237–41.
6 Bhatti, V, Kenney-Herbert, J, Cope, R, Humphreys, M. 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.
7 Swift, G, Nasir, M, Sheehan, JD, Casey, PR. Junior doctors' experience and knowledge of procedures in compulsory psychiatric admissions in Ireland. Ir J Psychol Med 2001; 18: 21–3.
8 Department of Health. Reference Guide to the Mental Health Act 1983. TSO (The Stationery Office), 2008.
9 Department of Health. Code of Practice, Mental Health Act 1983. TSO (The Stationery Office), 2008.
10 Office of Public Sector Information. Mental Health Act 2007 Chapter 12. TSO (The Stationery Office), 2007.
11 Humphreys, MS. Persuasion, coercion, medical paternalism or the Mental Health Act: the dilemma of detention in a general hospital. Scot Med J 1992; 37: 146–8.
12 Humphreys, MS. Junior psychiatrists and emergency compulsory detention in Scotland. Int J Law Psychiatry 1994; 17: 421–9.
13 Naeem, A, Gupta, B, Rutherford, J, Gachen, A, Roberts, S. The simulated mental health review tribunal – a valuable training tool for senior house officers? Psychiatr Bull 2007; 31: 2932.
14 Polit, DF, Beck, CT. Essentials of Nursing Research (5th edn). Lippincott Williams & Wilkins, 2006.
15 Modernising Medical Careers. A Reference Guide for Postgraduate Specialty Training in the UK (The ‘Gold Guide’). MMC, 2009.
16 Munro, BH. Statistical Methods for Health Care Research (5th edn). Lippincott Williams & Wilkins, 2005.
17 Humphreys, MS, Kenney-Herbert, JP, Cope, RV. How to keep up with the Mental Health Act. Adv Psychiatr Treat 2000; 6: 407–11.
18 Lynch, RM, Simpson, M, Higson, M, Grout, P. Section 136, The Mental Health Act 1983: levels of knowledge among accident and emergency doctors, senior nurses, and police constables. Emerg Med J 2002; 19: 295300.
19 Royal College of Psychiatrists. A Competency Based Curriculum for Specialist Training in Psychiatry: Core and General Module. Royal College of Psychiatrists, 2009.
20 Royal College of Psychiatrists. Specialist Training in Psychiatry: A Comprehensive Guide to Training and Assessment in the UK for Trainees and Local Educational Providers (Occasional Paper OP69). Royal College of Psychiatrists, 2010.
21 Harrison, J. Training in the Mental Health Act: see one, do one, teach one? Psychiatr Bull 1996; 20: 160–1.
22 Peay, J, Roberts, C, Eastman, N. Legal knowledge of mental health professionals: report of national survey. J Ment Health Law 2001; 5: 4455.
23 Affleck, GG, Peske, MA, Wintrob, RM. Psychiatrists' familiarity with legal statutes governing emergency involuntary hospitalisation. Am J Psychiatry 1978; 135: 205–9.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Abstract views

Total abstract views: 43 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 19th July 2018. This data will be updated every 24 hours.

Knowledge of mental health legislation in junior doctors training in psychiatry

  • Ovais Wadoo (a1), Aadil Jan Shah (a1), Nadarajah Jehaanandan (a1), Michelle Laing (a2), Manoj Agarwal (a1) and Peter Kinderman (a3)...
Submit a response

eLetters

Knowledge of mental health legislation in junior doctors training in psychiatry

Pratish B. Thakkar, Consultant Forensic Psychiatrist
19 January 2012

We read with interest the study by Wadoo et al focusing on the knowledge of mental health legislation in junior doctors training in psychiatry. As rightly stated by the authors, this is a concerning issue due to the possibility of inappropriate use of legislation that could potentially threaten patients' fundamental rights.

We would like to highlight couple of issues which are concerning. We felt that the knowledge of the doctors about various aspects of the MentalHealth Act will increase after they become section 12(2) approved and attend the mandatory training. We feel that most of the sections of the Act are only used by doctors after they are section 12(2) approved, however there are certain aspects of the law which apply before the approval. These are mostly used in emergencies and junior doctors are often the frontline staff of the Trust and will usually be the first port of call in emergencies, often outside working hours, when the support fromsenior and more experienced staff might not be as readily available.

We were anxious at the lack of knowledge about Section 5(2), where 65% of the trainees felt that they needed to examine the patient and 60% knew about the requirement to fill a form.

We feel that junior doctors in training are frequently called to prescribe medications for agitated or disturbed patients. In the current study the trainees' knowledge about the consent to treatment fell to 20% (statement in the study is: after 3 months, second opinion must be obtained if the patient does not consent). It can be concluded that the doctor may not be aware of if the patient's current 'consent to treatment form' (T2) or a second opinion (T3) is covering the emergency medication. There is a risk a patient may be prescribed medication without consent andwithout the legal paperwork completed.

We felt that such scenarios apart from damaging the therapeutic relationship could possibly lead to complaints or litigation against individual staff or the Trust.

Although it is reassuring that experience results in improved knowledge of the legislation, we agree that training in mental health law and its clinical implications should be emphasised at an earlier stage in the careers of junior doctors. Regular testing of competencies, as set out in the Royal College of Psychiatrists' curriculum, should follow attendance at mandatory formal training at induction and refresher courses.

... More

Conflict of interest: None declared

Write a reply

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *