Admitted and detained — community members and mental health review boards

Abstract

T his article presents the findings from research in 1997-98 which examined administrative review forums in Australia, including the operations of the Victorian Mental Health Review Board ("MHRB"). As part of a larger research project 25 hearings of the MHRB were observed. The MHRB is charged with responsibility for critical decisions regarding detention and the conditions associated with release of a person from inpatient to community care. Although hearings are essentially informal, participants are nevertheless entitled to the guarantees of procedural fairness. This raises dilemmas for the Board, for applicants, their families and advisers, as applicants may through their illness be unable to participate effectively in a process designed for their protection. The article examines how the MHRB actually conducts Its hearings, and the practice and fairness dilemmas associated with proceedings before the Board as presently constituted. It presents an analysis of member's perceptions about the value of the contribution made by their community member colleagues.

Mental Health Tribunals—Rights, Protection, or Treatment? Lessons from the ARC Linkage Grant Study?

“…Everything seems to be set up against the consumer, just in the order of the way the people speak. And they feel that they're on trial and their whole life is on trial and every misdemeanour that they've ever done is going to be raised (NSW advocate) This material indicates that, while there is quite a variety of views, there is tentative support for the hypothesis that 'distress' or 'powerlessness' is a significant factor, as postulated by Swain (2000). One explanation advanced was that there was a core of very ill and distressed consumers, where brevity was a humane way of 'tak[ing] account of serious and undisputed psychiatric ill-health and palpable patient distress'.…”

Service users’ experiences of mental health tribunals in Ireland: a qualitative analysis

“…The potential for MHTs to be experienced as adversarial is a repeated finding amongst previous studies (Dolan et al 1999;Ferencz & McGuire, 2000;Swain, 2000;Ferencz, 2003;Perkins, 2003b;Topp et al 2008;Carney, 2010;O'Donoghue et al 2010;Carney & Tait, 2011). However, as the narratives of some participants attest to, an adversarial environment is not inevitable.…”

“…The physical environment where MHTs have been conducted have been likened to 'court rooms', further exacerbating these negative aspects (Ferencz & McGuire, 2000). Service users have also questioned the procedural fairness of hearings, citing concerns of not attaining adequate legal representation and/or that their opinions were not adequately respected, listened to, or taken into account by the MHT board, thus resulting in their perceiving that the Admission Order was inappropriately affirmed (Dolan et al 1999;Ferencz & McGuire, 2000;Swain, 2000;Ferencz, 2003;Perkins, 2003a;Topp et al 2008;Carney, 2010;O'Donoghue et al 2010;Carney & Tait, 2011;Thom & Nakarada-Kordic, 2014). Research with consultant psychiatrists highlighted difficulties with the potentially adversarial nature of tribunals and the negative impact on therapeutic relationships (Jabbar et al 2010).…”

“…Various international studies have described a range of negative emotions and cognitions experienced by service users during the MHT process including anxiety, dissatisfaction, distress, confusion and powerlessness (Ferencz, 2003;Carney, 2010;Carney & Tait, 2011;Thom & Nakarada-Kordic, 2014). Additionally, service users have expressed concerns in relation to the adversarial nature of MHTs, and in particular have reported feeling intimidated and disempowered by the legalistic debate style employed and by the use of medical and legal terminology (Dolan et al 1999;Ferencz & McGuire, 2000;Swain, 2000;Ferencz, 2003;Perkins, 2003a;Topp et al 2008;Carney, 2010;O'Donoghue et al 2010;Carney & Tait, 2011;Thom & Nakarada-Kordic, 2014). The physical environment where MHTs have been conducted have been likened to 'court rooms', further exacerbating these negative aspects (Ferencz & McGuire, 2000).…”

Mental health legislation in contemporary India: the need for inter-sectoral dialogue

“…Experience in the UK does not appear to be substantially different (Perkins, 2003) and the Australian system has been criticised for tokenism (Swain, 2000). It has been suggested that the tribunals' reliance on imprecisely defined phrases such as 'lack of insight' and 'non-compliance' may be part of the problem (Diesfeld & McKenna, 2005).…”