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'Critically evaluate the role and the relationship between professionals and lay persons in the process of civil admissions under the Mental Health Act 1983.'

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Introduction

'Critically evaluate the role and the relationship between professionals and lay persons in the process of civil admissions under the Mental Health Act 1983.' The process of civil admissions under the Mental Health Act (MHA) 1983 may be viewed by civil libertarians as a violation of the individual's freedom. The state's justification for such a 'violation' is for the need to protect the individual concerned or to protect others in society. The Mental Health Act 1983 does not explicitly require that an individual would have to be 'dangerous' in order for that individual to be admitted to hospital. However, there has developed a 'dangerousness' criterion, (whether the individual would be considered to be 'dangerous' to himself or others) which is often mentioned as being the requirement for confinement; and it forms part of a public interest to preserve public peace and safety. However, as Bartlett and Sandland state; 'the desire to protect individuals from harming themselves is less evidently a public interest.'1 The paternalistic notion of the 'dangerousness' criterion is clearly evident. However, there is uncertainty over the application of the criterion and also confusion over how the person would be considered to be 'dangerous.' Furthermore, Price states that; ' a clear dichotomy should be created between parens patriae (detentions in the best interests of the individual him or herself) and police power (detentions for the protection of others) commitments.'2 The main provisions of the MHA 1983 regarding civil confinement are contained in sections 2 and 3.3 Section 2 of the MHA 1983 allows for ...read more.

Middle

In a study conducted by Bean, he found that; 'GPs, generally speaking, knew little of the [Mental Health] Act, and knew little of psychiatry.' 15 Therefore, GPs may feel that they have lesser authority than the specialists and may just be following the instructions of the specialists. Section 4 requires only one medical recommendation, which does not have to be made by a psychiatrist. This raises the issue whether section 4 is being used by ASWs as a method for saving time. However, the Code of Practice states that section 4 should not be used for 'administrative convenience.'16 There is an issue of the civil liberties of patients who have been admitted to hospitals, which has raised concerns regarding some of the roles and powers of medical staff, when restraining patients from leaving the hospital. Section 5 (4) allows for a nurse to be nominated by a Responsible Medical Officer, to hold a patient for up to six hours until the arrival of a medical practitioner who is authorised to detain the patient. Fennell states that: '...the holding power is one of the first signs of statutory recognition of the role of nurses in mental health care, it has been viewed with some circumspection and anxiety by nurses themselves, and has proved to be one of the most controversial areas of the 1983 Act.'17 The working relationship between professionals and lay persons in the civil admissions process is in reality much different than how the Code of Practice would have imagined it to be. ...read more.

Conclusion

London: HMSO. 8 Royal Commission on the Law relating to Mental Illness and Mental Deficiency 1954 - 1957, (The Percy Commission) (1957), Cmnd 169, London: HMSO, para. 403. 9 Cavadino, M., 'Mental Health Law in Context: Doctor's Order?,' (1989), Aldershot: London, p.117. 10 B (A) v B (L) (Mental Health Patient) [1980] 1 WLR 116. 11 [1974] QB 711. 12 Section 29 (4), Mental Health Act 1983. 13 [1999] 3 WLR 1. 14 Whitbread v Kingston and District NHS Trust (1997) The Times, 14 July. 15 Bean, P., (1980), 'Compulsory Admissions to Mental Hospitals', Chichester: John Wiley, p.162. 16 The Mental Health Act 1983 Code of Practice Department of Health and Welsh Office (1999) London: HMSO, para. 6.2. 17 Fennell, P., 'Detention and Control of Informal Mentally Disordered Patients,' [1984] Journal of Social Welfare Law, 345, p.345. 18 The Mental Health Act 1983 Code of Practice Department of Health and Welsh Office (1999) London: HMSO, para. 2.3. 19 Cavadino, M., 'Mental Health Law in Context: Doctor's Order?,' (1989), Aldershot: London, p.114. 20 Bean, P., (1980), 'Compulsory Admissions to Mental Hospitals', Chichester: John Wiley, p.157. 21 Walton, P., 'Reforming the Mental Health Act 1983: an approved social worker perspective,' Journal of Social Welfare Law 22 (4) 2000 401, p.407. 22 Fennell, P., 'The Mental Health Act Code of Practice,' Modern Law Review, Vol. 53, July 1990, 499, p.504. 23 The Mental Health Act 1983 Code of Practice Department of Health and Welsh Office (1999) London: HMSO, paras. 2.30 - 2.31. 24 Application No. 26494/95 (European Court of Human Rights , 30 March 2000). 25 Reform of the Mental Health Act 1983 (Cm 4480, 1999). 1 ...read more.

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