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Mental health legislation in Northern Ireland has always been separate from legislation in the rest of the UK; the Mental Health (Northern Ireland) Order (MHO) had been in place since 1986. In common with other jurisdictions, this legislation utilises the presence of mental disorder and risk as criteria for detention and involuntary treatment. The MHO has been replaced by the Mental Capacity Act (Northern Ireland) 2016 (MCA), an example of ‘fusion’ legislation in which impairment of decision-making capacity and best interests are the only criteria to be used when making decisions across health and social care. In this paper, we outline the development of the MCA to date, and discuss its potential to improve mental healthcare by placing the treatment of mental illness within the same legislative framework as physical illnesses.

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IRELANDABSTRACT -Background and objectives: Dissociative disorders remain relatively controversial diagnoses in British psychiatry. The aim of the current paper was to assess Northern Irish psychiatric patients with complex clinical presentations for dissociative disorders.Method: Twenty patients meeting operationally defined criteria for psychiatric complexity were blindly assessed by a psychiatrist in a diagnostic interview followed by a clinical psychologist in a structured interview.Results: Thirteen of the 20 participants were positive for at least one dissociative disorder. Those with a dissociative disorder had a range of co-morbid problems and all reported histories of childhood trauma and neglect.Conclusion: The psychiatric symptom profiles of dissociative disorders in Northern Ireland are similar to those reported in the literature. Complex psychiatric presentations offer a potential diagnostic clue for such conditions.