The Experts below are selected from a list of 98298 Experts worldwide ranked by ideXlab platform
Brendan D Kelly - One of the best experts on this subject based on the ideXlab platform.
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emergency mental Health Legislation in response to the covid 19 coronavirus pandemic in ireland urgency necessity and proportionality
International Journal of Law and Psychiatry, 2020Co-Authors: Brendan D KellyAbstract:Many countries have enacted, or are in the process of enacting, emergency mental Health Legislation in response to the global pandemic of Covid-19 (coronavirus). In Ireland, the Emergency Measures in the Public Interest (Covid-19) Act, 2020 amends the Mental Health Act 2001 to permit the Mental Health Commission to request an independent psychiatric report about an involuntary patient from any consultant psychiatrist who is not treating the patient (and not just those on its designated panel). This independent examination may occur 'in person', 'by other appropriate means', or even, 'due to the exigencies of the public Health emergency', not occur at all, once this is explained in the resultant report. The 2020 Act acknowledges that 'the exigencies of the public Health emergency' might hamper the independent psychiatrist's work and requires a written report from the patient's treating psychiatrist 'no earlier than the day before' the tribunal, in lieu of the psychiatrist physically attending a tribunal hearing, although, if possible, they will attend (i.e. phone in to) a tribunal held by conference call. The 2020 Act permits the Mental Health Commission to, if necessary, appoint tribunals 'consisting of one member who shall be a practising barrister or solicitor'. Such a tribunal shall, if possible, consult with a consultant psychiatrist if the reports from the independent psychiatrist and treating psychiatrist conflict or if it is otherwise 'necessary in the interest of the patient'. A tribunal can extend an involuntary order by a second period of 14 days 'of its own motion if the tribunal, having due regard to the interest of the patient, is satisfied that it is necessary'. Tribunals for current involuntary patients will be prioritised over retrospective tribunals for discharged patients; a tribunal can direct a witness to provide 'a written statement' rather than attending; and the patient can make written representation to the tribunal instead of physically attending a tribunal hearing, although they may attend (i.e. phone in to) a tribunal held by conference call. Psycho-surgery for involuntary patients is banned. While it is clear that revisions are urgent and necessary in light of Covid-19, the proportionality of these changes will depend on how, and the extent to which, they are used in practice. With good communication, efficient team-working and close adherence to professional codes of practice and ethics, it is hoped that these amendments will result in a review system that is as reasonable, robust and reassuring as the current, highly unusual circumstances permit.
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the world Health organization and mental Health law
2020Co-Authors: Richard M Duffy, Brendan D KellyAbstract:Since 1948, the World Health Organization (WHO) has done much to shape the evolution of mental Health law. Their initial measures were often indirect, but they have recently assertively articulated the importance of Legislation in Health, including mental Health. The inclusion of mental disorders in the International Classification of Diseases (ICD) since 1949 has helped standardize mental Health nomenclature in Legislation. Later iterations of the ICD, including descriptions of conditions, further improved diagnostic reliability. In 1996, the WHO’s Mental Health Care Law: Ten Basic Principles was one of the organization’s earliest attempts to directly shape mental Health Legislation. From 2001, Project Atlas helped to identify countries without mental Health Legislation and countries with grossly outdated laws. The WHO has sought to address these deficits recently as part of the WHO Mental Health Action Plan 2013–2020. The most direct attempt at influencing international mental Health law came in 2005 with the WHO’s Resource Book on Mental Health, Human Rights and Legislation. This provided extensive consideration of what should be addressed in mental Health law and policy, and examined coercive treatments in detail. With the publication of the United Nations’ Convention on the Rights of Persons with Disabilities (CRPD) in 2006, the Resource Book was withdrawn. Even so, the Resource Book remains the most comprehensive consideration of the legislative needs of people with mental illness. QualityRights is now the CRPD-concordant WHO publication relating to mental Health, including mental Health Legislation, and it contains an evaluation toolkit and teaching modules, among other resources.
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new Legislation new frontiers indian psychiatrists perspective of the mental Healthcare act 2017 prior to implementation
Indian Journal of Psychiatry, 2018Co-Authors: Richard M Duffy, Choudhary Laxmi Narayan, Nishant Goyal, Brendan D KellyAbstract:Context: The mental Healthcare act 2017 represents a complete overhaul of Indian mental Health Legislation. Aims: The aim of this study was to establish the opinions of Indian psychiatrists regarding the new act. Settings: Mental Health professionals in Bihar and Jharkhand were interviewed. Design: A focus group design was utilized. Materials and Methods: Key questions explored the positive and negative aspects of the act and the management of the transitional phase. All focus groups were recorded and transcribed. Analysis: Data were coded and analyzed using an inductive approach. Results: Many positive aspects of the new Legislation were identified especially relating to rights, autonomy, and the decriminalization of suicide. However, psychiatrists have significant concerns that the new Legislation may negatively impact patients and increase stigma. Psychiatrists held varying views on the proposed licensing and inspection of general hospital psychiatric units. Conclusions: Careful evaluation of the new Legislation is needed as the concerns raised warrant ongoing monitoring.
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rights laws and tensions a comparative analysis of the convention on the rights of persons with disabilities and the who resource book on mental Health human rights and Legislation
International Journal of Law and Psychiatry, 2017Co-Authors: Richard M Duffy, Brendan D KellyAbstract:Abstract Background Good mental Health Legislation is essential for ensuring high quality mental Health care and protecting human rights. Many countries are attempting to bring mental Health Legislation in line with the UN — Convention on the Rights of Persons with Disability (UN-CRPD). The UN-CRPD requires policy-makers to rethink the ‘medical model’ of mental illness and existing laws. It also challenges WHO guidelines on drafting mental Health law, described in the WHO Resource Book on Mental Health, Human Rights and Legislation (WHO-RB). Aims This study examines the relationship between the UN-CRPD and the WHO-RB. Methods It compares the documents, highlighting similarities and identifying areas of disagreement. The WHO-RB contains a checklist of human rights standards it recommends are met at national level. This study analyses each component on this checklist and identifies the relevant sections in the UN-CRPD that pertain to each. Results Both the UN-CRPD and WHO-RB address more than just acute exacerbations of illness, providing guidelines on, inter alia, treatment, education, occupation and housing. They are patient-centred and strongly influenced by social rights. The UN-CRPD, however, gives just superficial consideration to the management of acute illness, forensic and risk issues, and does little to identify the role of family and carers. Conclusion The UN-CRPD has evolved from disability research and strong advocacy organisations. Careful consideration is needed to enable it to address the specific needs encountered in mental illness. Both the UN-CRPD and WHO-RB highlight common tensions that must be resolved by clinicians, and provide some guidance for stakeholders who commonly need to observe one principle at the expense of another.
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concordance of the indian mental Healthcare act 2017 with the world Health organization s checklist on mental Health Legislation
International Journal of Mental Health Systems, 2017Co-Authors: Richard M Duffy, Brendan D KellyAbstract:India is revising its mental Health Legislation with the Indian Mental Healthcare Act 2017 (IMHA). When implemented, this Legislation will apply to over 1.25 billion people. In 2005, the World Health Organization (WHO) published a Resource Book (WHO-RB) on mental Health, human rights and Legislation, including a checklist of 175 specific items to be addressed in mental Health Legislation or policy in individual countries. Even following the publication of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) (2006), the WHO-RB remains the most comprehensive checklist for mental Health Legislation available, rooted in UN and WHO documents and providing the most systematic, detailed framework for human rights analysis of mental Health Legislation. We sought to determine the extent to which the IMHA will bring Indian Legislation in line with the WHO-RB. The IMHA and other relevant pieces of Indian Legislation are compared to each of the items in the WHO-RB. We classify each item in a binary manner, as either concordant or not, and provide more nuanced detail in the text. The IMHA addresses 96/175 (55.4%) of the WHO-RB standards examined. When other relevant Indian Legislation is taken into account, 118/175 (68.0%) of the standards are addressed in Indian law. Important areas of low concordance include the rights of families and carers, competence and guardianship, non-protesting patients and involuntary community treatment. The important legal constructs of advance directives, supported decision-making and nominated representatives are articulated in the Indian Legislation and explored in this paper. In theory, the IMHA is a highly progressive piece of Legislation, especially when compared to Legislation in other jurisdictions subject to similar analysis. Along with the Indian Rights of Persons with Disabilities Act 2016, it will bring Indian law closely in line with the WHO-RB. Vague, opaque language is however, used in certain contentious areas; this may represent arrangement-focused rather than realisation-focused Legislation, and lead to inadvertent limitation of certain rights. Finally, the WHO-RB checklist is an extremely useful tool for this kind of analysis; we recommend it is updated to reflect the CRPD and other relevant developments.
Sian Oram - One of the best experts on this subject based on the ideXlab platform.
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carers experiences of involuntary admission under mental Health Legislation systematic review and qualitative meta synthesis
BJPsych Open 6 (2) Article e19. (2020), 2020Co-Authors: Ruth Stuart, Syeda Ferhana Akther, Sonia Johnson, Alan Simpson, Karen Machin, Karen Persaud, Sian OramAbstract:BackgroundCarers are key providers of care and support to mental Health patients and mental Health policies consistently mandate carer involvement. Understanding carers' experiences of and views about assessment for involuntary admission and subsequent detention is crucial to efforts to improve policy and practice.AimsWe aimed to synthesise qualitative evidence of carers' experiences of the assessment and detention of their family and friends under mental Health Legislation.MethodWe searched five bibliographic databases, reference lists and citations. Studies were included if they collected data using qualitative methods and the patients were aged 18 or older; reported on carer experiences of assessment or detention under mental Health Legislation anywhere in the world; and were published in peer-reviewed journals. We used meta-synthesis.ResultsThe review included 23 papers. Themes were consistent across time and setting and related to the emotional impact of detention; the availability of support for carers; the extent to which carers felt involved in decision-making; relationships with patients and staff during detention; and the quality of care provided to patients. Carers often described conflicting feelings of relief coupled with distress and anxiety about how the patient might cope and respond. Carers also spoke about the need for timely and accessible information, supportive and trusting relationships with mental Health professionals, and of involvement as partners in care.ConclusionsResearch is needed to explore whether and how Health service and other interventions can improve the involvement and support of carers prior to, during and after the detention of family members and friends.
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patients experiences of assessment and detention under mental Health Legislation systematic review and qualitative meta synthesis
British Journal of Psychiatry Open, 2019Co-Authors: Syeda Ferhana Akther, Emma Molyneaux, Ruth Stuart, Sonia Johnson, Alan Simpson, Sian OramAbstract:Background: Understanding patient experiences of detention under mental Health Legislation is crucial to efforts to reform policy and practice. Aims: To synthesise qualitative evidence on patients' experiences of assessment and detention under mental Health Legislation. Method: Five bibliographic databases were searched, supplemented by reference list screening and citation tracking. Studies were included if they reported on patient experiences of assessment or detention under mental Health Legislation; reported on patients aged 18 years or older; collected data using qualitative methods; and were reported in peer-reviewed journals. Findings were analysed and synthesised using thematic synthesis. Results: The review included 56 papers. Themes were generally consistent across studies and related to information and involvement in care, the environment and relationships with staff, as well as the impact of detention on feelings of self-worth and emotional state. The emotional impact of detention and views of its appropriateness varied, but a frequent theme was fear and distress during detention, including in relation to the use of force and restraint. Where staff were perceived as striving to form caring and collaborative relationships with patients despite the coercive nature of treatment, and when clear information was delivered, the negative impact of involuntary care seemed to be reduced. Conclusions: Findings suggest that involuntary in-patient care is often frightening and distressing, but certain factors were identified that can help reduce negative experiences. Coproduction models may be fruitful in developing new ways of working on in-patient wards that provide more voice to patients and staff, and physical and social environments that are more conducive to recovery.
George Szmukler - One of the best experts on this subject based on the ideXlab platform.
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we should replace conventional mental Health law with capacity based law
British Journal of Psychiatry, 2016Co-Authors: George Szmukler, Brendan D KellyAbstract:As general medicine moves away from ‘paternalism’ and places an increasing emphasis on patient choice and autonomy, George Szmukler and Brendan D. Kelly debate whether conventional mental Health Legislation should be replaced with a model that focuses on the person9s decision-making capabilities.
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a model law fusing incapacity and mental Health Legislation
International Journal of Mental Health and Capacity Law, 2014Co-Authors: George Szmukler, Rowena Daw, John DawsonAbstract:An outline for a model law is presented here that would govern the non-consensual treatment of people who lack the capacity (or competence) to consent due to mental impairment, whether this is due to ‘mental disorder’ or ‘psychiatric disorder’ as conventionally conceived, or due to a ‘physical disorder’. Our aim in drafting this model law is to give coherent and practical expression to the case, previously made by two of the current authors, that separate Legislation authorising the civil commitment of ‘mentally disordered’ persons is unnecessary, and discriminatory, and should be replaced by new, comprehensive Legislation that would govern the non-consensual treatment of both ‘mental’ and ‘physical’ conditions. This new scheme – which we have described as the ‘fusion’ proposal – would be based squarely on incapacity principles: that is, on the impaired capacity of a person to make decisions about treatment, from whatever cause – whether this is due to schizophrenia, Alzheimer’s Disease, a learning disability, a confusional state due to infection, a cerebrovascular accident, a head injury, or any other mental impairment. A model statute of this kind, drafted largely by Rowena Daw, is presented here in skeleton form.
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the human rights act and mental Health Legislation
British Journal of Psychiatry, 2003Co-Authors: Jonathan Bindman, Samantha Maingay, George SzmuklerAbstract:The Human Rights Act 1998 came into force in October 2000, bringing the rights set out in the European Convention on Human Rights into domestic law. Although many aspects of English mental Health law have previously been tested against the European Convention on Human Rights in the European Court of
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mental Health Legislation is now a harmful anachronism
The Psychiatrist, 1998Co-Authors: George Szmukler, Frank HollowayAbstract:Two recent developments have served to highlight the contradictory and discriminatory nature of UK mental Health Legislation, and indeed all ‘mental Health’ acts. These are the Court of Appeal ruling in L. v. Bournewood (1997) and the increasing use of coercion in an attempt to alleviate society's fears of the dangers posed by the mentally ill in the community (Holloway, 1996). At the same time, a third development, the proposal for a Mental Incapacity Act, and the consequent Government Green Paper (Lord Chancellor's Department, 1997) Who Decides provides a framework rendering mental Health Legislation redundant.
Richard M Duffy - One of the best experts on this subject based on the ideXlab platform.
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the world Health organization and mental Health law
2020Co-Authors: Richard M Duffy, Brendan D KellyAbstract:Since 1948, the World Health Organization (WHO) has done much to shape the evolution of mental Health law. Their initial measures were often indirect, but they have recently assertively articulated the importance of Legislation in Health, including mental Health. The inclusion of mental disorders in the International Classification of Diseases (ICD) since 1949 has helped standardize mental Health nomenclature in Legislation. Later iterations of the ICD, including descriptions of conditions, further improved diagnostic reliability. In 1996, the WHO’s Mental Health Care Law: Ten Basic Principles was one of the organization’s earliest attempts to directly shape mental Health Legislation. From 2001, Project Atlas helped to identify countries without mental Health Legislation and countries with grossly outdated laws. The WHO has sought to address these deficits recently as part of the WHO Mental Health Action Plan 2013–2020. The most direct attempt at influencing international mental Health law came in 2005 with the WHO’s Resource Book on Mental Health, Human Rights and Legislation. This provided extensive consideration of what should be addressed in mental Health law and policy, and examined coercive treatments in detail. With the publication of the United Nations’ Convention on the Rights of Persons with Disabilities (CRPD) in 2006, the Resource Book was withdrawn. Even so, the Resource Book remains the most comprehensive consideration of the legislative needs of people with mental illness. QualityRights is now the CRPD-concordant WHO publication relating to mental Health, including mental Health Legislation, and it contains an evaluation toolkit and teaching modules, among other resources.
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new Legislation new frontiers indian psychiatrists perspective of the mental Healthcare act 2017 prior to implementation
Indian Journal of Psychiatry, 2018Co-Authors: Richard M Duffy, Choudhary Laxmi Narayan, Nishant Goyal, Brendan D KellyAbstract:Context: The mental Healthcare act 2017 represents a complete overhaul of Indian mental Health Legislation. Aims: The aim of this study was to establish the opinions of Indian psychiatrists regarding the new act. Settings: Mental Health professionals in Bihar and Jharkhand were interviewed. Design: A focus group design was utilized. Materials and Methods: Key questions explored the positive and negative aspects of the act and the management of the transitional phase. All focus groups were recorded and transcribed. Analysis: Data were coded and analyzed using an inductive approach. Results: Many positive aspects of the new Legislation were identified especially relating to rights, autonomy, and the decriminalization of suicide. However, psychiatrists have significant concerns that the new Legislation may negatively impact patients and increase stigma. Psychiatrists held varying views on the proposed licensing and inspection of general hospital psychiatric units. Conclusions: Careful evaluation of the new Legislation is needed as the concerns raised warrant ongoing monitoring.
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rights laws and tensions a comparative analysis of the convention on the rights of persons with disabilities and the who resource book on mental Health human rights and Legislation
International Journal of Law and Psychiatry, 2017Co-Authors: Richard M Duffy, Brendan D KellyAbstract:Abstract Background Good mental Health Legislation is essential for ensuring high quality mental Health care and protecting human rights. Many countries are attempting to bring mental Health Legislation in line with the UN — Convention on the Rights of Persons with Disability (UN-CRPD). The UN-CRPD requires policy-makers to rethink the ‘medical model’ of mental illness and existing laws. It also challenges WHO guidelines on drafting mental Health law, described in the WHO Resource Book on Mental Health, Human Rights and Legislation (WHO-RB). Aims This study examines the relationship between the UN-CRPD and the WHO-RB. Methods It compares the documents, highlighting similarities and identifying areas of disagreement. The WHO-RB contains a checklist of human rights standards it recommends are met at national level. This study analyses each component on this checklist and identifies the relevant sections in the UN-CRPD that pertain to each. Results Both the UN-CRPD and WHO-RB address more than just acute exacerbations of illness, providing guidelines on, inter alia, treatment, education, occupation and housing. They are patient-centred and strongly influenced by social rights. The UN-CRPD, however, gives just superficial consideration to the management of acute illness, forensic and risk issues, and does little to identify the role of family and carers. Conclusion The UN-CRPD has evolved from disability research and strong advocacy organisations. Careful consideration is needed to enable it to address the specific needs encountered in mental illness. Both the UN-CRPD and WHO-RB highlight common tensions that must be resolved by clinicians, and provide some guidance for stakeholders who commonly need to observe one principle at the expense of another.
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concordance of the indian mental Healthcare act 2017 with the world Health organization s checklist on mental Health Legislation
International Journal of Mental Health Systems, 2017Co-Authors: Richard M Duffy, Brendan D KellyAbstract:India is revising its mental Health Legislation with the Indian Mental Healthcare Act 2017 (IMHA). When implemented, this Legislation will apply to over 1.25 billion people. In 2005, the World Health Organization (WHO) published a Resource Book (WHO-RB) on mental Health, human rights and Legislation, including a checklist of 175 specific items to be addressed in mental Health Legislation or policy in individual countries. Even following the publication of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) (2006), the WHO-RB remains the most comprehensive checklist for mental Health Legislation available, rooted in UN and WHO documents and providing the most systematic, detailed framework for human rights analysis of mental Health Legislation. We sought to determine the extent to which the IMHA will bring Indian Legislation in line with the WHO-RB. The IMHA and other relevant pieces of Indian Legislation are compared to each of the items in the WHO-RB. We classify each item in a binary manner, as either concordant or not, and provide more nuanced detail in the text. The IMHA addresses 96/175 (55.4%) of the WHO-RB standards examined. When other relevant Indian Legislation is taken into account, 118/175 (68.0%) of the standards are addressed in Indian law. Important areas of low concordance include the rights of families and carers, competence and guardianship, non-protesting patients and involuntary community treatment. The important legal constructs of advance directives, supported decision-making and nominated representatives are articulated in the Indian Legislation and explored in this paper. In theory, the IMHA is a highly progressive piece of Legislation, especially when compared to Legislation in other jurisdictions subject to similar analysis. Along with the Indian Rights of Persons with Disabilities Act 2016, it will bring Indian law closely in line with the WHO-RB. Vague, opaque language is however, used in certain contentious areas; this may represent arrangement-focused rather than realisation-focused Legislation, and lead to inadvertent limitation of certain rights. Finally, the WHO-RB checklist is an extremely useful tool for this kind of analysis; we recommend it is updated to reflect the CRPD and other relevant developments.
Syeda Ferhana Akther - One of the best experts on this subject based on the ideXlab platform.
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carers experiences of involuntary admission under mental Health Legislation systematic review and qualitative meta synthesis
BJPsych Open 6 (2) Article e19. (2020), 2020Co-Authors: Ruth Stuart, Syeda Ferhana Akther, Sonia Johnson, Alan Simpson, Karen Machin, Karen Persaud, Sian OramAbstract:BackgroundCarers are key providers of care and support to mental Health patients and mental Health policies consistently mandate carer involvement. Understanding carers' experiences of and views about assessment for involuntary admission and subsequent detention is crucial to efforts to improve policy and practice.AimsWe aimed to synthesise qualitative evidence of carers' experiences of the assessment and detention of their family and friends under mental Health Legislation.MethodWe searched five bibliographic databases, reference lists and citations. Studies were included if they collected data using qualitative methods and the patients were aged 18 or older; reported on carer experiences of assessment or detention under mental Health Legislation anywhere in the world; and were published in peer-reviewed journals. We used meta-synthesis.ResultsThe review included 23 papers. Themes were consistent across time and setting and related to the emotional impact of detention; the availability of support for carers; the extent to which carers felt involved in decision-making; relationships with patients and staff during detention; and the quality of care provided to patients. Carers often described conflicting feelings of relief coupled with distress and anxiety about how the patient might cope and respond. Carers also spoke about the need for timely and accessible information, supportive and trusting relationships with mental Health professionals, and of involvement as partners in care.ConclusionsResearch is needed to explore whether and how Health service and other interventions can improve the involvement and support of carers prior to, during and after the detention of family members and friends.
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patients experiences of assessment and detention under mental Health Legislation systematic review and qualitative meta synthesis
British Journal of Psychiatry Open, 2019Co-Authors: Syeda Ferhana Akther, Emma Molyneaux, Ruth Stuart, Sonia Johnson, Alan Simpson, Sian OramAbstract:Background: Understanding patient experiences of detention under mental Health Legislation is crucial to efforts to reform policy and practice. Aims: To synthesise qualitative evidence on patients' experiences of assessment and detention under mental Health Legislation. Method: Five bibliographic databases were searched, supplemented by reference list screening and citation tracking. Studies were included if they reported on patient experiences of assessment or detention under mental Health Legislation; reported on patients aged 18 years or older; collected data using qualitative methods; and were reported in peer-reviewed journals. Findings were analysed and synthesised using thematic synthesis. Results: The review included 56 papers. Themes were generally consistent across studies and related to information and involvement in care, the environment and relationships with staff, as well as the impact of detention on feelings of self-worth and emotional state. The emotional impact of detention and views of its appropriateness varied, but a frequent theme was fear and distress during detention, including in relation to the use of force and restraint. Where staff were perceived as striving to form caring and collaborative relationships with patients despite the coercive nature of treatment, and when clear information was delivered, the negative impact of involuntary care seemed to be reduced. Conclusions: Findings suggest that involuntary in-patient care is often frightening and distressing, but certain factors were identified that can help reduce negative experiences. Coproduction models may be fruitful in developing new ways of working on in-patient wards that provide more voice to patients and staff, and physical and social environments that are more conducive to recovery.
