Five years after implementation: A review of the Irish Mental Health Act 2001

Ramsay, Hugh; Roche, Eric; O’Donoghue, Brian

doi:10.1016/j.ijlp.2012.11.011

Cited by 14 publications

(13 citation statements)

References 32 publications

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“…The MHA 2001 does not include provisions for supported decision making such as advance statements and nominated persons whose opinions must be taken into account by the treating consultant psychiatrist and has been described as 'a shortcoming' of the MHA 2001 (Ramsay et al 2013). Potential changes to the MHA 2001 to include 'advanced healthcare directives (AHDs)' as a means to achieve patient autonomy have been recom- The incorporation of a human rights-based model of mental illness is not without its challenges.…”

Section: Discussionmentioning

confidence: 99%

A comparison of mental health legislation in five developed countries: a narrative review

Cronin

Gouda

McDonald

et al. 2017

Ir. j. psychol. Med.

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ObjectivesTo describe similarities and differences in mental health legislation between five jurisdictions: the Republic of Ireland, England and Wales, Scotland, Ontario (Canada), and Victoria (Australia).MethodsAn in-depth examination was undertaken focussing on the process of involuntary admission, review of Admission Orders and the legal processes in relation to treatment in the absence of patient consent in each of the five jurisdictions of interest.ResultsAll jurisdictions permit the detention of a patient if they have a mental disorder although the definition of mental disorder varies between jurisdictions. Several additional differences exist between the five jurisdictions, including the duration of admission prior to independent review of involuntary detention and the role of supported decision making.ConclusionsAcross the five jurisdictions examined, largely similar procedures for admission, detention and treatment of involuntary patients are employed, reflecting adherence with international standards and incorporation of human rights-based principles. Differences exist in relation to the criteria to define mental disorder, the occurrence of automatic review hearings in a timely fashion after a patient is involuntarily admitted and the role for supported decision making under mental health legislation.

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Section: Discussionmentioning

confidence: 99%

A comparison of mental health legislation in five developed countries: a narrative review

Cronin

Gouda

McDonald

et al. 2017

Ir. j. psychol. Med.

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“…Or, les études examinant la fluctuation des taux avant et après les réformes législatives montrent une tendance générale vers une augmentation plutôt qu'une diminution des taux d'hospitalisation involontaire (de Stefano et Ducci, 2008). Une étude récente, menée en Irlande et portant sur l'influence de la réforme législative en matière d'hospitalisation involontaire, a démontré un effet positif à court terme, mais qui ne s'est pas maintenu dans le temps (Ramsay, Roche et O'Donoghue, 2013). Ces résultats, contraires à ce qui était attendu, laissent supposer que l'obligation légale ne permet pas à elle seule de susciter les changements requis dans la pratique hospitalière (Wallsten et Kjellin, 2004).…”

Section: Résumé De L'articleunclassified

Évaluation de l’implantation d’un nouveau protocole de garde en établissement : profil de la clientèle, audit de dossiers et recommandations

Leblanc

2014

smq

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Les difficultés d’application des réformes législatives visant à réduire l’hospitalisation involontaire des personnes qui présentent un danger pour elles-mêmes ou pour autrui ont été soulevées dans de nombreux rapports, tant au Québec qu’ailleurs. Pour aplanir ces difficultés, un nouveau protocole de garde en établissement a été élaboré et implanté dans la région de l’Outaouais. La présente étude a pour but d’évaluer son implantation et ce faisant, établir le profil des personnes mises sous garde en établissement. Les résultats indiquent que la majorité de ces personnes sont aux prises avec des troubles mentaux graves et que les professionnels perçoivent positivement le nouveau protocole, sans toutefois faire le nécessaire pour consigner de façon rigoureuse les données dans les formulaires requis. Il est recommandé de non seulement informer les professionnels sur la procédure légale, mais aussi s’assurer que la structure organisationnelle est propice à son implantation.Since the 1990s, legislative reforms have been undertaken in many Western countries to reduce involuntary hospitalization. Studies examining fluctuation rates before and after the legislative reform show a general trend toward an increase rather than a decrease in involuntary hospitalization rates (de Stefano & Ducci, 2008). In Quebec, many reports have shown that consent for psychiatric evaluation and hospitalisation for people who present an imminent danger to themselves or to others is difficult to obtain due to clinical, legal, and ethical considerations. To facilitate this process, a new protocol was developed and implemented following the training of 335 health workers and 85 medical doctors in 6 hospitals. Our study evaluated this protocol and established a profile of people who had been hospitalized against their will. Using a retrospective analysis, we examined the files of 179 patients who underwent a psychiatric evaluation process during an involuntary hospitalization. This file analysis allowed us to develop a better profile of these people and determine whether the required forms were present and how adequately they were filled out by the professionals. We also conducted a study with the professionals responsible for applying the new protocol to get a better idea of its characteristics (relative advantage, compatibility, simplicity, reversibility and observability) as well as the principles of consent and the obstacles to its implementation.Our study showed that that half of the patients were diagnosed with schizophrenia or another psychosis. Fifty-four point two percent (54.2%) of the patients were males, 79% were single or separated and only 18,4% were working. At the time of their crisis situation, 30,7% were brought to the hospital by police officers and 19% were already hospitalized. The remaining patients were brought in by ambulance, family members or they came in by themselves. Professional opinion of the new protocol was positive however they did not rigorously enter the data required in the new forms. The new form was present...

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“…The Mental Health Act 2001 duly resulted in the removal of indefinite detention orders (that existed under the Mental Treatment Act 1945); introduction of new involuntary admission procedures; automatic, independent review of detention orders by tribunals; free legal representation and independent psychiatric opinions for patients before tribunals; and establishment of the Mental Health Commission to oversee implementation of the Act and standards of care. Many of these changes promote human rights, dignity and patients' autonomous exercise of capabilities (O'Donoghue & Moran, 2009;Ramsay et al 2013). While some increase in workload is probably inevitable in order to realise these benefits fully, future revisions of procedures related to the legislation could usefully seek to minimise additional administrative workloads for all involved.…”

Section: Main Findingsmentioning

confidence: 99%

“…There is strong evidence that the new legislation both protects human rights (O'Donoghue & Moran, 2009;Ramsay et al 2013) and presents significant challenges to psychiatrists, stemming from increased workloads, more conflicted relationships with service-users and adversarial mental health tribunals (Jabbar et al 2010).…”

Section: Introductionmentioning

confidence: 99%

Implementing the Mental Health Act 2001 in Ireland: views of Irish general practitioners

Jabbar¹,

Aziz²,

Kelly³

2013

Ir. j. psychol. Med.

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Five years after implementation: A review of the Irish Mental Health Act 2001

Cited by 14 publications

References 32 publications

A comparison of mental health legislation in five developed countries: a narrative review

A comparison of mental health legislation in five developed countries: a narrative review

Évaluation de l’implantation d’un nouveau protocole de garde en établissement : profil de la clientèle, audit de dossiers et recommandations

Implementing the Mental Health Act 2001 in Ireland: views of Irish general practitioners

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