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Health Act (health + act)

Distribution by Scientific Domains

Psychology	30%
Medical Sciences	30%
Humanities and Social Sciences	15%

Kinds of Health Act

mental health act

Selected Abstracts

Pros and cons of using the mental health act for severe eating Disorders in Adolescents

EUROPEAN EATING DISORDERS REVIEW, Issue 1 2009
Agnes Ayton
Abstract Background In England and Wales the compulsory treatment of young people with severe eating disorders is controversial. There is a concern that such treatment may impair patient autonomy and negatively influence the outcome. In this study, based in a specialist hospital, we compared patients treated under parental consent with those detained under the Mental Health Act: their characteristics and outcome up to 12 months after discharge. Results 34 patients were informal (treated under parental consent) (age: 16.2,±,1.3 years) and 16 were treated under Section 3 of the Mental Health Act (age: 16.2,±,1) in a 3-year period. Detained patients had an earlier age of onset (12.2,±,5 vs. 14.3,±,1.8) and more previous hospitalisation. On admission, their psychosocial functioning (Children's Global Assessment Scale (C-GAS): 13.6,±,2 vs. 26.9,±,9; Health of the Nation Outcome Scale for Children and Adolescents (HONOSCA): 41.7,±,5 vs. 31.9,±,5) were worse than voluntary patients', they had a higher level of co-morbid depression (BDI: 38.1,±,15.6 vs. 26.6,±,12.4) and a higher rate of suicidal behaviour. All physical and psychosocial measures improved substantially and clinically significantly by discharge and there was no statistically significant difference at this stage between the two patient groups. Two informal patients died within a year after discharge (6.3%), but there were no deaths amongst the detained patients. Comments In contrast with previous findings in adults, the outcome for detained patients was similar to that for informal patients, despite the former having more severe presentation on admission. There was no evidence of higher mortality in the detained group. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

Optimization of double-layer absorbers on constrained sound absorption system by using genetic algorithm

INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN ENGINEERING, Issue 3 2005
Ying-Chun Chang
Abstract As investigated by the Occupational Safety and Health Act (OSHA) in 1970, noise is highly responsible for the psychological and physiological ills to workers. Therefore, the noise control for an enclosed system with high echo effect becomes essential. Besides, the thickness of adopted sound absorber is occasionally constrained for maintenance, the interest in minimizing the noise under space constraint is then arising. In this paper, the shape optimization of double-layer absorber together with genetic algorithm (GA) is presented. Before optimization, one example is tested and compared with the experimental data for accuracy check of mathematical model. Thereafter, a simple optimal program in dealing with pure tone noise of 350 Hz has been pre-run to verify the correctness of genetic algorithm before the design in full band noise being performed. Results show that both the accuracy of mathematical model and the correctness of GA method are acceptable. Consequently, this study may provide a novel scheme with GA in solving the shape optimization of sound absorber on the constrained sound absorption system. Copyright © 2004 John Wiley & Sons, Ltd. [source]

Appeals by the elderly against compulsory detention under the Mental Health Act 1983

INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 12 2006
Amar Shah
No abstract is available for this article. [source]

Section 5(4) (The nurse's holding power): patterns of use in one mental health trust (1983,2006)

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2010
R. ASHMORE bsc(hons) rmn ma pgce dip coun
Accessible summary ,,Section 5(4) (Nurses' holding power) allows a mental health nurse to detain a patient admitted informally to hospital for treatment of a mental health problem for up to 6 h or until they are assessed by a doctor. ,,The use of the holding power has risen significantly since its introduction in 1983 to an average of 1442 per annum (range 789,1953 per annum). ,,The study identifies a number of factors in relation to the use of Section 5(4) including: gender, clinical setting, temporal patterns and medical response time. ,,Although the majority of patients are assessed by a doctor within 4 h of the holding power being applied, 8.3% are detained for 6 h or longer. There is a need to explore this and other issues further. Abstract The majority of studies exploring the use of Section 5(4) (Nurses' holding power) of the Mental Health Act 1983 are now dated, report on small numbers and have been undertaken over relatively short periods of time. A retrospective study was undertaken which sought to identify the factors associated with the use of the section in one mental health trust over a 24-year period (1983,2006). Section 5(4) was applied on 803 occasions, an average of 33.4 times per annum. The majority of sections were applied to female patients (58.4%) by male nurses (54.9%) within adult acute inpatient settings (93.4%). Significant differences were noted in the use of the section over the 24-h period but not for month of the year or day of the week. A total of 349 (43.5%) sections were implemented during doctors' ,office hours' (Monday,Friday, 9:00 h to 17:00 h). The mean length of time spent on the section was 140 min; 80.6% of patients were assessed by a doctor within 4 h; and 8.3% remained on the section for 6 h or more. The holding power was converted to another section of the Act on 642 (80%) occasions. A similar, multi-sited prospective study could be undertaken to validate the findings of this study. [source]

Expanding roles within mental health legislation: an opportunity for professional growth or a missed opportunity?

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2007
J. HURLEY msc nursing
This paper aims to highlight both the necessity, and the way forward for mental health nursing to integrate proposed legislative roles into practice. Argued is that community mental health nursing, historically absent from active participation within mental health law in the UK, is faced with new and demanding roles under proposed changes to the 1983 Mental Health Act of England and Wales. While supporting multidisciplinary training for such roles, the imperative of incorporating nursing specific values into consequent training programs is addressed through the offered educative framework. This framework explores the issues of power, ethics, legislative thematics and application to contemporary service structures. [source]

Stress and burnout in community mental health nursing: a review of the literature

JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2000
D. Edwards mphil, bsc (hons)
There is a growing body of evidence that suggests that many community mental health nurses (CMHNs) experience considerable stress and burnout. This review aimed to bring together the research evidence in this area for CMHNs working within the UK. Seventeen papers were identified in the literature, seven of which looked at stress and burnout for all members of community mental health teams (CMHTs) and the remaining 10 papers focused on CMHNs. The evidence indicates that those health professionals working as part of community teams are experiencing increasing levels of stress and burnout as a result of increasing workloads, increasing administration and lack of resources. For CMHNs specific stressors were identified. These included increases in workload and administration, time management, inappropriate referrals, safety issues, role conflict, role ambiguity, lack of supervision, not having enough time for personal study and NHS reforms, general working conditions and lack of funding and resources. Areas for future research are described and the current study of Welsh CMHNs is announced. This review has been completed against a background of further significant changes in the health service. In the mental health field, specific new initiatives will have a significant impact on the practice of community mental health nursing. A new National Framework for Mental Health, along with a review of the Mental Health Act (1983), will undoubtedly help to shape the future practice of mental health nursing. [source]

Assessing the viability of treatment rights for prisoners with personality disorder: Substance or substantive?

PERSONALITY AND MENTAL HEALTH, Issue 3 2009
Leon McRae
Personality disorder (PD) has long been criticized as a diagnosis, not least for the issue of its supposed untreatability. This has precluded many offenders with PD from receiving treatment for their disorder in a secure hospital, with detention in the potentially deleterious penal environment the result. However, transfers for public protection continue to occur. A further problematic issue for treatment considerations when diversion from prison hangs in the balance is the removal of the need for proposed treatment to provide a therapeutic benefit under the recently amended Mental Health Act 1983. In light of these developments, this paper considers the significance of human rights instruments, such as the European Prison Rules 2006, which aim to offer rights to treatment, giving the offender with a diagnosis of PD access to adequate and sustaining treatment, both in prison and secure hospitals. Copyright © 2009 John Wiley & Sons, Ltd. [source]

The geographies of crisis: exploring accessibility to health care in Canada

THE CANADIAN GEOGRAPHER/LE GEOGRAPHE CANADIEN, Issue 3 2002
KATHLEEN WILSON
There is increasing concern in Canada that the health care system is in a state of crisis. It is argued that reductions in federal government transfers to the provinces have resulted in a health care system characterized by under-funding in key areas and policy decisions based more on provincial fiscal concerns than the health needs of their constituents. Provincial governments have responded to reduced levels in federal funding by undertaking aggressive restructuring tactics such as the closure of hospitals and the deinsuring of medical services from provincial health plans. The end result of this restructuring, as argued by the media, consumer groups and indeed some health researchers, is a state of crisis' (i.e., lower levels of accessibility, long waiting lists, overcrowding in hospitals and increasing costs of medication). One crisis theme often mentioned is that fiscal decisions of various kinds are reducing economic and geographic accessibility, one of the five principles of the Canada Health Act (CHA) that defines the very essence of the Canadian health care system. Using data from the 1998-99 National Population Health Survey (NPHS), this paper explores the extent to which an accessibility crisis exists within the Canadian health care system by examining access to health care services and the barriers encountered in trying to access services in each of the ten provinces. The results show that approximately 6.0 percent of Canadians report access problems, with values ranging from 4.5 percent in Newfoundland to 8.3 percent in Manitoba. Regional variations in barriers to accessing care were also observed. In particular, geographic accessibility appears to be a main barrier to care in Atlantic Canada while economic accessibility emerges as a main barrier to care in Western Canada. We discuss these findings in the context of the current debates on the Canadian health care system ,crisis'. De plus en plus de Canadiens s'inquiétent que leur systéme de soins de santé soit en état de crise. On défend l'idée selon laquelle la réduction des paiements de transfert aux provinces par le gouvernement fédéral serait responsable de l'état d'un systeme de santé caractérisé par un sous-financement dans les domaines-clés et des décisions politiques de santé basées, non pas sur les besoins des membres de la société canadienne, mais sur la fiscalité provinciale. Les gouvernements provinciaux ont réagi à la réduction du financement fédéral par une tactique de restructuration agressive (fermeture d'hôpitaux et retrait de services médicaux des programmes d'assurance de santé provinciaux). Selon les médias, les groupes de consommateurs et même les chercheurs en soins de santé, cette restructuration a eu pour effet un système en état de ,crise' (diminution de l'aecès aux services, longues fetes d'attente, hôpitaux surchargés, augmentation des coûts des médicaments etc). Un des thèmes récurrent est celui des décisions flscales de toutes sortes qui entraînent une baisse de l'accessibilité financière et géographique. Cette accessibilité est pourtant un des cinq principes de la Loi canadienne sur la santé définissant l'essence même du système de santé au Canada. Utilisant les données tirèes de l'Enquête nationale sur la santé de la population, 1998-99 et examinant l'accès aux services de santé et les obstacles rencontrés dans les 10 provinces canadiennes, cet article évalue dans quelle mesure une crise d'accessibilité existe au sein du système de santé canadien. Les résultats démontrent qu'environ 6.0 pour cent des Canadiens ont rencontré des problèmes d'accessibilité, avec des variantes allant de 4.5 pour cent à Terre-Neuve jusqu'à 8.3 pour cent au Manitoba. On observe aussi des variantes régionales dans les obstacles rencontrés. L'accessibilité géographique en particulier semble un obstacle mqjeur dans les régions de l'Atlantique, alors que l'accessibilite financière semble être un obstacle majeur dans l'Ouest du Canada. Ces résultats sont présentés dans le contexte des débats actuels sur l'existence dune, ,crise' dans le système de santé au Canada. [source]

New Labour's PPI Reforms: Patient and Public Involvement in Healthcare Governance?

THE MODERN LAW REVIEW, Issue 2 2009
Peter Vincent-Jones
Following a first wave of reform at the beginning of the decade, the system of patient and public involvement in healthcare governance is being further overhauled under the Local Government and Public Involvement in Health Act 2007 and the Health and Social Care Act 2008. The current reforms reflect a significant shift in dominant political discourse from an earlier concern with patient and public involvement towards a more exclusive focus on consumer choice and economic regulation, with collective voice and citizen participation at best playing a subordinate part in the government's NHS modernisation agenda. While there is some potential for increased responsiveness in the new arrangements, the overall effect is likely to be a weakening of the foundations of democratic decision making in the governance of healthcare in England. [source]

Autonomy, Guardianship and Mental Disorder: One Problem, Two Solutions

THE MODERN LAW REVIEW, Issue 5 2002
Genevra Richardson
The law in England and Wales governing both the provision of medical care in the case of adults with incapacity and the provision of care and treatment for mental disorder presents serious problems for the principle of patient autonomy. The adult with incapacity has no competence either to consent to or to refuse medical treatment but the law provides no statutory structure for substitute decision making on that adult's behalf. On the other hand the law does allow a person with mental disorder to be treated for that disorder despite his or her competent refusal. The nature of these inconsistencies is considered and the implications which flow from the singling out of mental disorder are examined with reference to experience in two Australian jurisdictions. The current proposals for reform of the Mental Health Act are then considered in the light of the conclusions drawn. [source]

Legal dilemmas for clinicians involved in the care and treatment of children and young people with mental disorder

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 4 2010
M. Bowers
Abstract Background The 2008 revised Mental Health Act Code of Practice describes the legal framework governing the admission to hospital and treatment of children and young people for mental disorders as complex. Clinicians are required to be conversant with common law principles as well as the Mental Health Act (MHA), Children Act, Mental Capacity Act (MCA), Family Law Reform Act, Human Rights Act, and the United Nations Convention on the Rights of the Child. Professionals working with the MHA and the MCA have a legal duty to have regard to the respective Codes of Practice (MHA Code and MCA Code). In addition there is a need to keep up-to-date with developments in case law. The recent guidance from the National Institute for Mental Health in England, ,The Legal Aspects of the Care and Treatment of Children and Young People with Mental Disorder' draws all of the legal regimes together and suggests pointers on the most appropriate course of action when the regimes overlap. Discussion This paper will aim to highlight legal dilemmas relating to the care and treatment of under 18-year-olds for mental disorder and to discuss the impact of these on clinical practice. The new legal framework will be discussed with reference to hypothetical cases. Key issues include age and maturity, capacity, deprivation of liberty and the zone of parental control (ZPC). Conclusions It is essential that clinicians are aware of their responsibilities within the new legal framework in order to avoid becoming a target for litigation. This paper is aimed at meeting the recommendation for clinicians to be aware of their responsibilities and engage in appropriate training. [source]

Are perceptions of parenting and interpersonal functioning related in those with personality disorder?

CLINICAL PSYCHOLOGY AND PSYCHOTHERAPY (AN INTERNATIONAL JOURNAL OF THEORY & PRACTICE), Issue 3 2001
Evidence from patients detained in a high secure setting
We explored the widely-held assumption that dysfunctional interpersonal behaviour, a key characteristic of personality disorder, is associated with adverse experiences in childhood in a sample of patients detained in high secure care. We obtained Parental Bonding Inventory (PBI) and Chart of Interpersonal Relations in Closed Living Environment (CIRCLE) data from 79 patients detained at a high secure hospital. This comprised 48 with the legal classification (1983 Mental Health Act) of Psychopathic Disorder (PD) and 31 with the legal classification of Mental Illness (MI). On the PBI, the PD group had significantly lower care scores and increased protection scores compared with the MI group; the latter reported care and protection scores similar to those from published norms. The CIRCLE scores also demonstrated significantly different interpersonal functioning between the PD and MI groups, with each group typically plotted in opposing halves of the interpersonal circle (IPC). Although the PDs showed abnormalities in both the PBI and CIRCLE in the expected direction, there were no clear associations between aspects of abnormal parenting and adult dysfunctional interpersonal behaviour within this group. This finding did not confirm our hypothesis and we discuss possible explanations. Copyright © 2001 John Wiley & Sons, Ltd. [source]