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)

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