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Key Elements of Mental Health Law Reform: A Clinical Perspective
Brendan Kelly
Mater Misericordiae University HospitalUniversity College Dublin
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Ireland meets 80 out of 166 standards (48.2%)
Chief deficits Promoting rightsRights of families and carersVoluntary patientsVulnerable groupsEconomic and social rights
Capacity legislation
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Arrangement-focussed view of justice
Realization-focussed view of justice
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n = 81 recently detained individuals
Treatment was beneficial 78%Knew they had been detained 86%Tribunal made this easier to accept 46%Negative impact on family relationships 28%Negative impact on doctor-patient relationship 27%
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n = 820 GPs
Not user-friendly 63%
Increased workload 27%
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n = 321 psychiatrists
Training was satisfactory 84%Increased workload 69%Decreased time with service-users 27%Changes in relationships with service-users 41%….more legalistic, conflicted relationships
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Re-define “voluntary patient”Strengthen “best interests” dimensionIntroduce cumulative tribunal “case-law”Reduce legalismBroaden criteria for Circuit Court appeal …“approved mental health professionals”?
Mental capacity legislation...
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Best ways to increase observance of human rights of the mentally ill:
Social policyMental health policyMental health law
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Kelly BDPenrose’s Law in Ireland: Ecological Analysis of Psychiatric Inpatients and Prisoners, 1963-2003. Irish Medical Journal 2007; 100: 373-4
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Best ways to increase observance of human rights of the mentally ill:
Social policyMental health policyMental health law
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“Medicine is a social science, and politics nothing but medicine at a larger scale”
Rudolf Virchow(1821-1902)
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Key Elements of Mental Health Law Reform: A Clinical Perspective
Brendan Kelly
Mater Misericordiae University HospitalUniversity College Dublin