Strange bedfellows? Nurses as Responsible Clinicians under the Mental Health Act (England &amp; Wales)

Veitch, Paul; Oates, Jennifer

doi:10.1111/jpm.12366

Cited by 4 publications

(7 citation statements)

References 27 publications

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“…In jurisdictions such as England and New Zealand, nurses are now formally integrated in the CTOs’ enforcement process and may be designated as responsible clinicians (McKenna et al . 2006; Veitch & Oates 2017). This role is still little studied from the perspective of nursing practice (McKenna et al .…”

Section: Introductionmentioning

confidence: 99%

“…One example is the implementation of community treatment orders (CTOs), the use of which is increasing in several countries (Kisely et al 2020). In jurisdictions such as England and New Zealand, nurses are now formally integrated in the CTOs' enforcement process and may be designated as responsible clinicians (McKenna et al 2006;Veitch & Oates 2017). This role is still little studied from the perspective of nursing practice (McKenna et al 2006;Veitch & Oates 2017), although mental health legislation formalizing nurse's involvement gives them numerous duties in terms of prevention, enforcement, adjustment, and justification of CTOs (Griffith 2019).…”

Section: Introductionmentioning

confidence: 99%

“…In jurisdictions such as England and New Zealand, nurses are now formally integrated in the CTOs' enforcement process and may be designated as responsible clinicians (McKenna et al 2006;Veitch & Oates 2017). This role is still little studied from the perspective of nursing practice (McKenna et al 2006;Veitch & Oates 2017), although mental health legislation formalizing nurse's involvement gives them numerous duties in terms of prevention, enforcement, adjustment, and justification of CTOs (Griffith 2019). The involvement of nurses in coercion is changing and is therefore no longer limited to the technical application of seclusion and restraint, despite the fact that the organizing work of nurses in the very specific context of coercion is still largely invisible (Allen 2015).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Coercion in psychiatric and mental health nursing: A conceptual analysis

Paradis-Gagné

Pariseau‐Legault

Goulet

et al. 2021

Int J Mental Health Nurs

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The use of coercion in psychiatric and mental health nursing is a major challenge, which can lead to negative consequences for nurses and patients, including rupture in the therapeutic relationship and risk of injury and trauma. The concept of coercion is complex to define and is used in different ways throughout the nursing literature. This concept is defined broadly, referring to both formal (seclusion, restraint, and forced hospitalization), informal (persuasion, threat, and inducement), and perceived coercion, without fully addressing its evolving conceptualizations and use in nursing practice. We conducted a concept analysis of coercion using Rodgers’ evolutionary method to identify its antecedents, attributes, and associated consequences. We identified five main attributes of the concept: different forms of coercion; the contexts in which coercion is exercised; nurses’ justification of its use; the ethical issues raised by the presence of coercion; and power dynamics. Our conceptual analysis shows the need for more nursing research in the field of coercion to achieve a better understanding of the power dynamics and ethical issues that arise in the presence of coercion.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Coercion in psychiatric and mental health nursing: A conceptual analysis

Paradis-Gagné

Pariseau‐Legault

Goulet

et al. 2021

Int J Mental Health Nurs

View full text Add to dashboard Cite

show abstract

“…Whilst there has been some primary research and discussion of the AMHP role (Coffey & Hannigan, 2013;Morriss, 2015;Watson, 2015) so far there has been just one research paper on 'non-medical' ACs (Ebrahim, 2017). Lack of information on the motivation and experiences of ACs has previously been noted (Veitch & Oates, 2017). In this paper we present findings from the first national survey of non-medical ACs, offering insight into the characteristics of this (thus far) small group.…”

Section: Introductionmentioning

confidence: 92%

“…The MHA 2007 extension of professional roles has been viewed by some as characteristic of neoliberal government policy, whereby cost saving (through getting less well paid professionals and individual service users to take on more responsibility and risk) is positively framed as distributed power and increased professional and personal agency (Ramon, 2008;Veitch & Oates, 2017). What is different between now and 2007 is the economic and political context of mental health care in the United Kingdom.…”

Section: Introductionmentioning

confidence: 99%

Non-medical approved clinicians: Results of a first national survey in England and Wales

Oates

Brandon

Burrell

et al. 2018

International Journal of Law and Psychiatry

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The 2007 amendments to the Mental Health Act, 1983 in England and Wales enabled non-medics to take on the role of legally 'responsible clinician' for the overall care and treatment of service users detained under the Act, where previously this was the sole domain of the psychiatrist as Responsible Medical Officer. Following state sanction as an 'Approved Clinician', certain psychologists, nurses, social workers or occupational therapists may be allocated as a Responsible Clinician for specific service users. Between 2007 and 2017 only 56 non-medics had become Approved Clinicians. This study reports on a first national survey of 39 non-medical Approved Clinicians. Descriptive statistics and thematic analysis of free text answers are presented here. The survey results show the limited uptake of the role, save for in the North Eastern region of England. Non-medical Approved Clinicians were motivated by a combination of altruistic intents (namely a belief that they could offer more psychologically-informed, recovery-oriented care) and desire for professional development in a role fitting their expertise and experience. Barriers and facilitators to wider uptake of the role appear to be: organisational support, attitudes of psychiatrist colleagues and a potentially lengthy and laborious approvals application process. The survey is a starting point to further research on the interpretation and implementation of the range of statutory roles and responsibilities under English and Welsh mental health law.

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Multi-professional approved clinicians’ contribution to clinical leadership

Ebrahim

2018

JMHTEP

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Purpose The purpose of this paper is to explore how multi-professional approved clinicians (MPACs), responsible for the care of patients detained under the Mental Health Act (2007), can enable clinical leadership in mental health settings. Design/methodology/approach A questionnaire was completed by clinical psychology and mental health nursing practitioners in a mental health trust in the UK working towards or having gained approved clinician (AC) status, identifying barriers to implementation of the roles and enablers. Qualitative interview data were also gathered with psychiatrists, clinical psychologist and Mental Health Nurse ACs (three in each group). Findings There are a number of barriers and enablers of distributed leadership promoted by the MPAC role. Themes identified focused on enabling person-centred care, clinical leadership and culture change more broadly within mental health care. The AC role is supporting clinical leadership by a range of professionals, promoting patient choice by enabling access to clinicians with the appropriate skills to meet needs. Clinical leadership roles are promoting links between organisational priorities, teams and patient care, fostering distributed leadership in practice. Research limitations/implications This project reflects the views of a limited number of practitioners within one organisation which limits generalisabilty. Practical implications Organisations need clear strategies linked to workforce development and implementation of the roles to capitalise on their potential to support clinical leadership and person-centred care. Originality/value This study provides initial qualitative data on potential benefits and challenges of implementing the role.

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Strange bedfellows? Nurses as Responsible Clinicians under the Mental Health Act (England & Wales)

Cited by 4 publications

References 27 publications

Coercion in psychiatric and mental health nursing: A conceptual analysis

Coercion in psychiatric and mental health nursing: A conceptual analysis

Non-medical approved clinicians: Results of a first national survey in England and Wales

Multi-professional approved clinicians’ contribution to clinical leadership

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