The Grounds Patients are Detained Flashcards
How is the ‘least restrictive requirement’ worded in section 2 of the legislation?
In admission for assessment - ‘nature of degree which warrants the detention of P’
How is the ‘least restrictive requirement’ worded in section 3?
‘A nature of degree which makes it appropriate for him to receive medical treatment in hospital’.
What does section 2 and 3 presuppose about treatment?
That if it can be administered outside the hospital setting, there is no justification for a hospital admission.
How have courts dealt with the issue of P’s challenging their renewals after being on periods of leave?
That admission for treatment cannot be made or renewed if its sole purpose is to ensure compliance with a medical treatment regime while P is living in the community.
Why is the Hallstrom judgement important?
Admission for treatment has no applicability to those whom it is intended to admit and detain for a purely nominal period which no necessary treatment will be given.
What was the ruling in R v Barking?
Leave of absence can be integral to therapy and a P’s detention can be renewed when P’s are on leave
What was the ruling R (DR) v Mersey Care NHS Trust?
There has been some sympathy with the need to exercise compulsory hospital powers to ensure compliance with medication regimes.
What was the ruling in R (CS) v MHRT?
The court ruled that renewal of admission for treatment was appropriate in the case of a P who was permitted to live at home and attend ward rounds every 4 weeks.
What is the second Winterwerp criteria?
“Of a nature or degree”
What does of a nature or degree which makes it appropriate for him to receive medical treatment in hospital mean?
MHRT, ex p Smith; a tribunal held that the nature of the P’s illness justified detention. It was found that there was a continued need for caution because his mental state had been subject to marked fluctuations.
What did Phil Fennel say?
If the P’s history indicates a strong likelihood of relapse, P’s should re-admitted to hospital before the relapse occurs. It is not necessary to wait for the P’s psychosis to ripen before he can be admitted to hospital under section.
What did the Mental Health Act Commission consider in the situation of the relapsing patient?
There must be reliable evidence of a continuing unsoundness of mind, the nature of which warrants compulsory detention. The evidence should be sufficiently compelling.
What was the ruling of BB v South London?
Tribunal incorrectly determined that the nature of the applicants disorder presented a risk of violence, even though there was little recent evidence of such a risk.
What happened in CM v Derbyshire?
UT required evidence as to the risk posed by the nature of the disorder.
What was the reasoning for quashing the tribunals refusal of discharge under CM?
The tribunals decision was set aside because they had not established that there would be a significant deterioration of the P’s condition in the near future. Assessments of future risk were speculative and longer-term.
What was the ruling in Stojanovski?
The ECtHR upheld a violation of article 5 on the basis that the disorder was no longer of a nature of degree to warrant compulsory confinement.
What case illuminates the interface between physical and mental health problems?
GJ v Foundation Hospital
When should dangerousness be established?
determined by section 2 or 3
Section 2 dangerousness threshold?
The patient ought to be detained in the interests of his own health or safety or with a view to the protection of other persons.
Section 3 dangerousness threshold?
It is necessary for the health and safety of patient or for the protection of others that he should receive treatment/continue to receive treatment.
What if a person no longer meets criteria for compulsory admission or section 20 renewal of detention?
She cannot continue to be detained and a tribunal must order her discharge.
What did Hutchinson Reid v UK rule?
When a person poses a risk of harm, ECHR institutions have confirmed that continued detention is not unlawful, provided that they continue to suffer from a mental health problem.
What does the protection of others mean?
Protecting others is considered a legitimate justification for the detention of people with mental health problems under our current MH legislation.
Where is the notion of protection of others enshrined?
In the Code of Practice 4.7
Factors to consider is the nature of the risk to other people arising from P’s mental disorder and likelihood that harm will result and the severity of any potential harm.
