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13.05.10 Mental health act

Section three
  • Mental disorder
    • Organic or non-organic
    • Including personality disorder
  • Of a nature or degree
    • i.e. Even if no current symptoms, the nature of a patient's past illness can be sufficient
  • Making it appropriate
    • Doctor-focussed
  • That they be under hospital detention for treatment
  • On the basis of their health, safety or the protection of others
    • Protection on others should be a separate act
  • Appropriate medical treatment should be available
    • Defined extremely broadly (education, rehab..)
    • Only the purpose need be to treat - i.e. Doesn't need to be likely to help, or even reasonable
  • For the disorder, its symptoms or its manifestations
    • What does this mean in personality disorders?


Antisocial PD problem

  • Retained capacity, but essentially untreatable
  • So MHA had to be defined widely enough to allow for their detention (if dangerous)
    • => Huge discretion for clinicians

Dangerous and Severe Personality Disorder (DSPD)
  • Not really a diagnosis at all
  • Introduced in 2001 to allow detention of bad 'ns
  • Michael Stone: Murder of Lin and Megan Russell in 1998


Personality disorders (DSM-IV)

Cluster Description Disorder
A Odd or eccentric behaviour Paranoid Schizoid


Schizotypal
B Dramatic or emotional behaviour Antisocial


Borderline Histrionic


Narcissistic
C Anxious or avoidant behaviour Avoidant Dependent


Obsessive– compulsive


Notes
  • Section 3 = Section 37 (which is from courts)
  • Professor George Szmukler - No need for MHA, can use MCA
  • Mental disorder = "Impairment or disturbance in functioning of mind or brain resulting from a disability or disorder of mind or brain"
  • MAPPA / MARAC for dangerous folk
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