Mental Health Act 1983 - Essay Example

People who are found to have mental health problems are mostly treated in the community or in hospitals on a voluntary basis and are supposed to havethe same rights as everyone else. They may also be called as ‘informal’ patients. Under a particular section of the Mental Health Act 1983, a small number of people are compulsorily detained and they do have some different set of rights. Such people who are brought to the hospital and compulsorily detained are known as ‘formal’ patients. However, informal patients when are found to be attempting to leave before complete cure are held under section five of the act and may become formal patients. The Mental Health Act of 1983 is very multifaceted, complex, involves sections and covers many different areas, like compulsory admission to hospital, consent to admittance, treatment, right to appeal, patient’s guardianship, patient’s background and his involvement in criminal proceedings and various other factors. The Act involves a separately published regularly updated Code of Practice too. This code of practice is a guide to the implementation of the Mental Health Act. For a person to be assessed for compulsory admission in the mental health centre, under the Act, firstly the person should be suffering from some kind of mental disorder. This is specified in the Act to mean mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind. According to the second section of the law, a person can be detained for up to 28 days for assessment purposes. The condition for this kind of detention of the patient is that the patient must be suffering from mental disorder to such an extent or degree which compulsorily demands or warrants the detention of the patient in a hospital for assessment or for medical treatment after the assessment for some limited period of time. He/she should be assessed, admitted, detained and treated in the interests of his own health or safety, or for the safety of other persons. Diane is a 45 years old single lady who lives alone. In the past, Diane had worked as a buyer for Marks and Spencer for many years and was made redundant. She left and started a horticulture business with a friend. Unfortunately, the business failed and Diane incurred debts. She decided to sell her house in order to buy a much smaller property and have money to pay off debts and start afresh. She was admitted into hospital under the section 2 of the mental health Act 1983 with police escort. Apparently, her sister had notified the mental health service about her concerns for Diane’s mental state. Diane was not pervious known to mental health service. At first, visits were made to Diane’s by staff from the mental health intake team. Diane had refused them entry into her home only briefly stating that she is mentally sound and able and had refused to be assessed. On a follow-up visit, she allowed staff into her house and she was assessed. She was told that her sister had raised concerns about her mental state. Diane was surprised about this because she had not heard from her sister for months. She said that her sister had not returned her telephone calls and had sent back her Christmas card unopened. The team felt that Diane was not at risk or in crisis and then discharged her. A letter was sent to Diane explaining this with contact information should she need help in the future. However, two months later, her sister made another call to the mental health service insisting that Diane is mental ill and in need of help. She exercised her right as a nearest relative under the Mental health Act section 26 and made an application for Diane’s admission for treatment. Once again, Diane had refused staff entry into her house. She was now highly suspicious of people. She said things are been moved about in her house and that documents had gone missing and only to reappear weeks later. She refused to go into hospital and sectioned and was brought into hospital shouting and screaming. She eventually settled down and was assessed and diagnosed as having paranoid psychosis and she was prescribed olazipine 2mg twice daily. She was told of her rights to appeal to the tribunal Board within 14 days of being detained. She decided to appeal against been detained under the mental health Act because she feels that she does not have a mental health illness and is baffled at been in hospital. Whilst in the ward, Diane attended OT twice daily and took part in activities and games. There were some concerns among the nursing team because some felt after communicating with Diane that she showed no sign of having mental illness. She did talk about people moving things round in her house and did say that her sister and her nephew (sister’s son with who Diane was once very close to) do have the spare keys to her house. She also let known that she is not particularly close to her sister and that she also has a handicapped sister who is cared for in a specialist home and that she is the trustee of her handicapped sister’s estate. Subsequently, Diane was discharged from section after deliberation by the Tribunal Board and as an informal patient discharged herself from ward. There are various kinds of problems suffered by people who have mental disorder. Apart from the consequences of their sickness they do have to bear the name as a mentally disorderly person throughout their life time. Society may not give them a good name or respect even if they are found to be delivered completely from their mental sickness. Unfortunately, some people are of the false belief that mental disorders are never cured completely in the entire life time of the person. People around them (relatives and friends) will always be suspecting them and may take them to hospital without their consent. According to the Mental Health Act any relative or anybody of close relation to the person can report the mental disorder of a person. This provision, however, is found to be misused highly. As there is no equipment that can exactly measure the degree of mental disorder in a person, the opinion of the person who is always close to the patient is taken for granted. The person claim of the person that he is psychologically fit may not be considered by the hospital people, court or others. The testimony given by others will be considered and the person will be assessed to find whether he needs any treatment or not. There were cases when several false reports were given about some people, falsely stating that they do show the signs of mental insanity. In such cases good investigation has to be done in order to confirm whether the person really do have mental disorders. Even enemies can simply give a false report and can degrade the status of the person, in the society. Good investigation and medical checking is mandatory in each and every case. The Mental Health Act1983 Section 3 gives certain rules regarding admission for treatment also. A person (with psychiatric disorder) can be detained in the care centre for treatment up to six months (can be renewed). This is the case when the patient is proved to be suffering from severe mental impairment, mental illness, mental impairment or psychopathic disorder and his mental disorder is of an extent or degree which makes it appropriate and essential for him to receive medical treatment in hospital. For people with psychopathic disorder or mental impairment, such mode of treatment is expected to alleviate or prevent the worsening of his condition. According to the Act “It is necessary for the health or safety of the patient or for the protection of other persons that he should receive such treatment and it cannot be provided unless he is detained under this section.” Sections 2 and 3 give necessary guidance concerning submitting an application for the admittance and treatment of the disorderly person. An Approved Social Worker (ASW) or a persons ‘nearest relative’ (if necessary and appropriate) can submit an application for a people who suffer from psychiatric ailments. However, two medical practitioners need to support the application. Moreover, under Section 3 of the Act, the approved social worker must attain the consent of the ‘nearest relative’ of the patient, in order to submit the admission. If the approved social worker could not gain the approval of the nearest relative the application cannot be proceed even though the court proceedings can be considered to overrule a nearest relative who objects unreasonably. In the case when the patients nearest relative objects the admission unreasonably (Section 3 of the Act) an application can be send to the County Court under section 29 of the act for transferring the functions of the nearest relative to the local Social Services or another person. Concerning the discharge of the patient, according to both Sections 2 and 3, the patient can be discharged by The Responsible Medical Officer (RMO), The Hospital Managers or by a The Nearest Relative. The relative, but, should give 72 hours notice to the hospital managers, who in turn may overrule the request. In the case that discharge would be dangerous to the patient or to others, The RMO can refuse the request. In such case the nearest relative can bring the matter before a Mental Health Review Tribunal. According to The Mental Health Act 1983, the patient can appeal to the Mental Health Review Tribunal. This appeal must be submitted within 14 days of detention according to Section 2 of the Act. One appeal from the patient may be made within the six-month period under Section 3. Legal Aid is also available in order to pay a solicitor to represent somebody for a Tribunal. Patients who want to appeal can also make it to the Hospital Managers. Section 4 allows the admission of a patient for assessment in an emergency up to 72 hours in the case of urgent necessity. The application should be supported by the recommendation of one registered medical practitioner, in this case. Informal patients, when they attempt to leave hospital, they are held as per the Section 5 (2) or 5 (4) and may become formal patients. Section 5 (2) speaks about the doctor’s holding power. This permits the detention of a person for up to 72 hours. Nurses possess a holding power according to Section 5 (4). Mental health nurses care for people with mental disorders in hospitals and in the community, enabling them to overcome their ill health. They have certain rights over the patient. Their holding power can only be applied for 6 hours or till the doctor arrives with the power to exercise doctors special holding power. A police officer, as per Section 135 can enter the premises and remove the patient to a place of better (using force if need be) safety for up to 72 hours. This can only be done when an approved social worker has received a warrant from the magistrates court, when there is sufficient reason to doubt that the patient is being neglected or ill treated or not properly kept in the premises or when he is living alone and is not able to manage his life. Mathew Roberts is a 3rd year student in the mental health nursing branch. He has been attached to a nurse practitioner in the A&E department of the district hospital for his last placement. Patients with mental disorders are accepted in that hospital. A 30 year old man arrived with his elderly mother. The man was clearly disturbed and had frightening aggressive outbursts. With the help and supervision of the qualified nurse, Mathew could calm down the man down, behaving to him in a non-threatening manner and trying to understand the source of his distress. This approach taken by mental health care nurses is known as ‘de-escalation’. The interpersonal and behavioral skills gained by the trained health care nurse can help the patient in this case. A health care nurse can assess the behavior and psychological needs in order to decide whether the patient should be admitted to care. The nurse can refer the patient to a nurse-led community treatment team which will provide him intensive support, treatment and care. The nurse can learn the patient’s nature and treat him accordingly. These nurses would take care of the patients with mental health problems in hospitals as well as community, helping them to overcome their ailments in order to bring them back to normal life as soon as possible. Everybody has episodes of depression, stress anger and fear in their lives, but there are certain times for certain people when they need care and professional help. One among six adults suffers from one or other form of mental illness. Mental illnesses have become very common these days. Depression and other psychological ailments do spread as other contagious diseases. Mental health nurses are at the front line in providing necessary support to the patients by coordinating with psychiatrists, social workers and others. The setting for mental care has been changed nowadays from hospital to community. Nurses may work in patient’s house, in small residential units, and also in local health centers properly planning and delivering the treatment. Nurses are key players in a multi-agency team. They do have one-to-one personal relationship with patients, which is the important part of the treatment process. A good environment and proper care and love can cure almost 40% of all the psychological sickness. Nurses are the central figures in this type of treatment. In this therapeutic relationship between the nurse and the patient nurses possess the ability to listen and draw information to help people find means of coping with their psychological and other problems. This may involve the patient’s family, friends and other contacts. Another challenge for the nurse is to identify and check if the patient is at the risk of harming themselves or others. Mental health nurses are also mostly responsible for co-coordinating a patients care in the community. Mental health nurses need to deal with people of all ages and from different backgrounds helping them gradually come to terms with their problems. They must be able to learn the nature, characters and other personality traits of the patient and should proceed with treatment accordingly. They need patience, perseverance, understanding, love and care and kindness to provide the required help to psychologically unhealthy people. References Barker, P (ed) (2003). Psychiatric and Mental Health Nursing: The craft of caring. London: Arnold. ISBN 0-340-81026-2. Boyd, M.A.; Nihart, M.A. (eds.) (1998). Psychiatric Nursing: Contemporary practice. Philadelphia: Lippincott. ISBN 0-397-55178-9. Kemp, D.R. (1993) International Handbook on Mental Health Policy. Greenwood Press. Kent, A. J. & Hersen M.A. (2000) Psychologists Proactive Guide to Managed Mental Health Care. Lawrence Erlbaum Associates. 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