The role of second health professionals under New Zealand mental health legislation

Abstract

The development of generic statutory roles in mental health care has been the subject of discussion by New Zealand nurses for the past decade. One such role is that of second health professional in judicial reviews of civil commitment. Issues identified by New Zealand nurses have also been raised in England, where it seems that nurses are likely to assume the role of Approved Mental Health Worker under English mental health law. A survey of mental health nurses found that few had received any preparation for the role of second health professional and 45% did not feel adequately prepared for the role. Some of these issues are reflected in a New Zealand inquiry which resulted in the Ministry of Health developing a written report form for second health professionals. However, the form has the potential to reduce the mental health nursing role to a narrow legal role. Statutory roles such as that of second health professional challenge mental health nurses to critically reflect on the conceptual and ethical basis of their practice. While traditional concepts such as therapeutic relationships and advocacy need to be reviewed in light of these changes, nurses need to be vigilant in articulating the moral and clinical basis of their roles. The development of guidelines for he second health professional role is suggested as a way of supporting clinical practice in this area.

The second professional and detention renewal: an exploration of a generic statutory role

“…3 Although a high degree of professional acceptance was a positive finding for a role which is statutory (100% were happy to act in the role again), this outlook deserves to be accompanied by education and training in order to fairly equip professionals undertaking generic statutory roles that have demonstrable levels of responsibility and accountability. Introducing such roles without making adequate training provisions appears to undermine noble aims and it has been noted that social interests (such as safeguards) cannot be served when those enacting the legislation are expected to assume statutory roles with no training and without the benefit of contextual written guidance.…”

“…Introducing such roles without making adequate training provisions appears to undermine noble aims and it has been noted that social interests (such as safeguards) cannot be served when those enacting the legislation are expected to assume statutory roles with no training and without the benefit of contextual written guidance. 3 It was therefore unsurprising that an exploration of the generic statutory role of the second professional (which did not have educational input prior to its introduction) highlighted specific knowledge deficits and an apparent under-awareness of the associated ethical issues. Ultimately, this finding challenges both the assumption that professionals are ready to undertake statutory roles, or that they are as generic as the role apparently expects.…”

“…3 In this study, 86% I have had extensive experience of attending Tribunal and Manager's hearings, and giving feedback from a nursing perspective I have been qualified and working on this site for six years I have 30 years experience as a Nurse, knowledge of the Consultant, and have kept up to date with changes in the Act Knowledge of the patient I have known (the patient) for several years Due to the nature of the client's mental health difficulties, I feel the renewal was appropriate I have worked with (the patient) and this allows me an informed impression of his mental health, and an ability to form a balanced opinion on benefits to mental health against the least restrictive option Table 5 Advice…”

“…It also put on record the need for specific training for the role of the second health professional. 3 In the UK in 2007, the Mental Health Act 1983 (the Act) was amended, with new legislation coming into effect in November 2008 and introducing generic statutory roles for the first time, with one such role being that of the second professional in the renewal of authority for detention under section 3 or 37 of the Act.…”

Education in forensic psychiatry

“…The justice system has given mental health technicians and nurses working at forensic psychiatric services an important role in helping patients in custody, those who have received a judgement and those under rehabilitation programs [35]. These professionals benefit from training programs, especially on confidentiality, ethics, research and other legal aspects [36][37][38].…”