Capacity, consent, and mental health legislation: Time for a new standard?

O’Brien, Anthony

doi:10.5172/conu.2010.34.2.237

Cited by 14 publications

(9 citation statements)

References 36 publications

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“…As it relates to consent, capacity is complex and difficult to define. Consent therefore is a static term and a threshold construct (O'Brien 2010). In the first instance, capacity relates to the legal status of a decision.…”

Section: Discussionmentioning

confidence: 99%

I had no other option: Women, electroconvulsive therapy, and informed consent

Clarke

Barnes

Ross

2017

Int J Mental Health Nurs

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Electroconvulsive therapy (ECT) is a controversial procedure used in the management of depression. Whilst it may be administered under mental health legislation, it is usually given to people who voluntarily consent. At the practice level, the consent process for ECT requires a detailed explanation of the procedure. The person consenting must have capacity to make this decision, and consent must be given freely and without coercion. Research using a feminist narrative approach unexpectedly highlighted the issue of potential coercion in the context of explaining the procedure. In-depth interviews were used to understand seven women's accounts of deciding to receive ECT. A thematic analysis of their narratives uncovered a shared concern with how they consented to the treatment. Four subthemes were identified that related to the way in which they provided their consent: (i) 'Not enough information'; (ii) 'I had no other choice'; (iii) 'Just go along with it'; and (iv) 'Lacking capacity'. A consent process that includes elements of passive coercion and a lack of timely and appropriate information influences the way some women make decisions. These factors can disempower women at the point of decision-making. A practice shift is needed where women are enabled to have control over decisions. Further, there is a need to adhere more rigorously to noncoercive practice when obtaining consent.

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Section: Discussionmentioning

confidence: 99%

I had no other option: Women, electroconvulsive therapy, and informed consent

Clarke

Barnes

Ross

2017

Int J Mental Health Nurs

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“…There would clearly be benefits in adding a further supportive layer to patient's decision-making. This would reflect faith in the assumption that patients have capacity to make decisions (O'Brien, 2010) and should be supported with their decisions (Reilly & Atkinson, 2011). Nursing lays claim to being the professional providing holistic care to patients within mental health settings (Quinn, Happell, & Welch, 2013b;Saunamäki, Andersson, & Engström, 2010); however, responses from patient participants suggest nurses are not currently providing support for intimate sexual relationships.…”

Section: Discussionmentioning

confidence: 99%

Supporting the Sexual Intimacy Needs of Patients in a Longer Stay Inpatient Forensic Setting

Quinn

Happell

2015

Perspect Psychiatr Care

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The findings suggest that current guidelines regarding sexual intimacy in acute inpatient settings may not be appropriate in long-term facilities, with a need for guidelines to specifically address this setting. Furthermore, support for sexual intimacy needs of patients was identified as a strong need for patients and they believed not currently met. Nurses have an important role to play as part of their holistic approach to care and barriers to providing this aspect of care must be overcome to ensure patients' rights are respected.

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“…In response, a growing number of clinicians and academics have called for the abolition of separate mental health legislation in favour of a generic mental incapacity act (for examples see Dawson & Szmukler 2006;Large, Ryan, Nielssen, & Hayes 2008;O'Brien, 2010;Ryan 2011;Wand & Chiarella 2006). Concerns have been expressed about the preventative detention component of mental health legislation that allows for apprehension of individuals in advance of violence (a different standard applied to mental health treatment without consent than to unconsented treatment for physical health problems) and that separate mental health legislation framed around a category of people and based on a risk criteria reinforces stigma and stereotypes about the characteristics of people with mental illness.…”

Section: Implications For Clinical Practicementioning

confidence: 99%

Investigating the Evidence for the Effectiveness of Risk Assessment in Mental Health Care

Wand

2011

Issues in Mental Health Nursing

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Risk assessment pervades mental health care policy, practice, and legislation. This paper aims to establish the research evidence for the effectiveness of a risk assessment approach in mental health. A search was conducted of the professional literature on risk assessment in mental health, specifically seeking any research on the effectiveness of risk assessment in reducing risk of harm to self or others. The search found limited research on the effectiveness of risk assessment. "Structured professional judgment" possibly reduces aggression risk but there is no evidence that risk assessment is effective in relation to self-harm or suicide reduction. The implications for practice are discussed and alternatives to a risk assessment approach are considered.

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Capacity, consent, and mental health legislation: Time for a new standard?

Cited by 14 publications

References 36 publications

I had no other option: Women, electroconvulsive therapy, and informed consent

I had no other option: Women, electroconvulsive therapy, and informed consent

Supporting the Sexual Intimacy Needs of Patients in a Longer Stay Inpatient Forensic Setting

Investigating the Evidence for the Effectiveness of Risk Assessment in Mental Health Care

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