Mental Health Act 2001• E.g. establishes Mental Health Tribunals• Rights-based focus• Influenced by European Convention on Human Rights 1950• “Best interests” of service user (patient)• Autonomy / privacy / dignity / bodily integrity / information rights
Issues with 2001 Act• “Voluntary” patients• Paternalistic interpretation by courts• Sections on treatment are weak• Does not solve issues of wards of court and other issues of mental capacity• UN Convention on Rights of Persons with Disabilities 2006
Mental Health Tribunals Consultant Chairperson: Another Psychiatrist Barrister / Solicitor Person• Chairperson must have 7 yrs practice immediately before appointment• Psychiatrist may be retired psychiatrist employed by HSE or Approved Centre provided retired within 7 years. s.48(2)• Other person must not be in previous categories or be a doctor or nurse 12
Functions of MHTs• Main function: automatic review of detention of patients detained involuntarily• Other functions: – Role in decisions concerning psycho-surgery – Role in transfers to Central Mental Hospital• No role in following – Treatment / medication decisions – Criminal matters – separate Review Board 13
Limited Powers• Tribunal has limited powers – only two main choices: confirm or revoke order• Arguable that Tribunals need to have more extensive powers, e.g. to order conditional discharge; defer discharge until place available 14
Representation• Patient normally uses services of legal representative assigned by Commission• Important protection for patient’s rights• Training• Legal Aid Scheme + Terms and Conditions• Fees 15
Statistics• 1,771 MHT hearings in 2011• 145 (8%) revoked at hearing – “Revoked” means MHT ordered patient’s release• 3,163 involuntary admissions / renewals/ regradings• 1,397 (44%) revocations before hearing by Responsible Consultant Psychiatrist 16
Frequency of Reviews• While automatic reviews are desirable, they do not necessarily fully comply with Article 5• “The detainee’s access to the judge should not depend on the good will of the detaining authority.” – Rakevich v Russia (2003) 17
• Tribunal must confirm or revoke admission or renewal order• Section 18 – Excusing Procedural Failings:• To affirm order, MHT must be satisfied that – patient is “suffering from a mental disorder” and – certain procedures have been complied with, or, “if there has been a failure to comply with [these procedures], that the failure does not affect the substance of the order and does not cause an injustice.” s.18(1)(a)(ii)• If revokes order, must direct that patient be discharged 19
Two schools of thought• One school: S.18 can only be used to excuse minor failures of an insubstantial nature• Other school: MHTs can excuse virtually any procedural defect, unless it is in reckless disregard of the statutory scheme 20
Amnesty - examples• Should be audits of MHT hearings• Person subject to detention > 3 months should have right to apply to MHT for review• If individual re-graded from involuntary to voluntary before hearing, MHT hearing should be held• Act should state that only minor failures of compliance … will be excused• Patient should have right to nominate person to attend MHT with them• Legal Rep should be appointed within 24 hours• Legal reps should have access to client records 22
A particular slide catching your eye?
Clipping is a handy way to collect important slides you want to go back to later.