The healthcare provision for the elderly with a history of offending is under-researched and suffers from a lack of adequate services. Although the number of offences committed by older patients is low, research suggests they are more likely to re-offend, and have significant legal and psychiatric histories (Tomar et al., 2005). Older offenders also have complex medical problems such as neurological disease, including dementia, heart disease, stroke, and hypertension (Lewis et al., 2006).
It is predicted that there will be a significant growth in the population aged over 65 years in the U.K., from 15.9% in 2000 to 23.3% in 2050, with the fastest growth rate being among the oldest old (United Nations, 2005). In line with such growth, there will be a commensurate increase in the population of older people suffering from psychiatric conditions. This will lead to a demand for increased health care services and the need for reorganization and prioritization of resources channeled into health care for this group.
Aims and MethodA postal survey of consultant psychiatrists was carried out to assess their level of knowledge about the role of the person representing the responsible authority at a mental health review tribunal (MHRT).ResultsConsultants generally had a low level of knowledge and understanding of their responsibilities as representatives, which increased since appointment and with experience of MHRTs. They thought it appropriate that they continue representing the detaining authority in most cases, but recognised training needs.Clinical ImplicationsPostgraduate training and continuing professional development should address the competencies required for the representative role. Trusts should review their practice in respect of legal representation at MHRTs.
The four principles include: 1. Respect for Autonomy: According to this principle, patients should be treated as rational, autonomous agents, making their own decisions about their lives.
The next 2 years will see radical changes to the way medical training is delivered. First, the old apprenticeship and time served model will no longer be applicable. Second, from August 2004 the European Work Time Directive (EWTD) applies to trainees in the same way that it applies to all other grades (European Union, 1993, 2000). August 2005 will bring the first full intake into foundation programmes and will see the implementation of Modernising Medical Careers (MMC) (Department of Health, 2003). Further in 2005, the General Medical Council's (GMC's) new requirements for revalidation will come into force (GMC, 2003).
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