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Chapter 2 - Legislation Relevant to the Management of Violence by Persons With Mental Disorders

from Section 1 - General Aspects of Management

Published online by Cambridge University Press:  09 May 2023

By
Anthony Beschizza ,
Dominic Dougall  and
Masum Khwaja
Edited by
Masum Khwaja  and
Peter Tyrer
Masum Khwaja
Affiliation:
Imperial College of Science, Technology and Medicine, London
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
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Summary

This chapter provides an overview of the legislative frameworks that are relevant to the management of violence by persons with mental disorders in the United Kingdom. Three jurisdictions apply (England and Wales, Scotland and Northern Ireland). Individual frameworks and their variants are not discussed in detail; rather, substantial differences relevant to the management of violence are highlighted. Core principles guiding routine medical practice of ‘consent’ and ‘do no harm’ remain relevant in the management of violence, and legislation provides a framework when coercion may be necessary to manage an acute violent act, the immediate risk of further violence or the longer-term risk of violence. Pertinent legislation is discussed, including the Human Rights Act 1998, and mental health and mental capacity acts. Deprivation of Liberty Safeguards (DoLS), which are soon to be replaced by the Liberty Protection Safeguard Scheme (LPS), community treatment orders (CTOs) and review of the Mental Health Act are also discussed.

Keywords

Legislationviolencemental disordershuman rights actmental capacity actmental health actDoLsLPSCTOsrestriction orders
Type
Chapter
Information
The Prevention and Management of Violence
Guidance for Mental Healthcare Professionals
 , pp. 15 - 24
Publisher: Cambridge University Press
Print publication year: 2023

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References

European Court of Human Rights. Osman v. United Kingdom [2000] 29 ECHR 245 https://hudoc.echr.coe.int/eng#{%22dmdocnumber%22:[%22696134%22],%22itemid%22:[%22001-58257%22]} [Accessed 25.4.2022].Google Scholar
Equality and Human Rights Commission. Human rights: Human lives. A guide to the Human Rights Act for public authorities. 2014. www.equalityhumanrights.com/en/publication-download/human-rights-human-lives-guide-human-rights-act-public-authorities [Accessed 25.4.2022].Google Scholar
European Court of Human Rights. Herczegfalvy v. Austria, 24 September 1992 (A/244) (1993) 15 EHRR 437 1993.Google Scholar
Office of the Public Guardian. Mental Capacity Act Code of Practice: Giving guidance for decisions made under the Mental Capacity Act 2005. Published 2013. Updated 2020. www.gov.uk/government/publications/mental-capacity-act-code-of-practice#history [Accessed 25.4.2022].Google Scholar
Gilburt, H. A tale of two Acts: The Mental Health Act, the Mental Capacity Act, and their interface. The Kings Fund 2021. www.kingsfund.org.uk/blog/2021/02/tale-two-acts-mental-health-act-and-mental-capacity-act [Accessed 25.4.2022].Google Scholar
Department of Health and Social Care. Statutory guidance. Code of Practice: Mental Health Act 1983. Published 15 January 2015. Updated 31 October 2017. www.gov.uk/government/publications/code-of-practice-mental-health-act-1983 [Accessed 25.4.2022].Google Scholar
Department of Health, NI. Mental Capacity Act (Northern Ireland) 2016 – Deprivation of Liberty Safeguards: Code of Practice, November 2019. www.health-ni.gov.uk/publications/mcani-2016-deprivation-liberty-safeguards-code-practice-november-2019 [Accessed 25.4.2022].Google Scholar
Pountney v. Griffiths; Regina v. Bracknell Justices, Ex parte Griffiths HL 1976 [1976] AC 314.Google Scholar
Moncrieff, J. and Smyth, M. Community treatment orders – a bridge too far? Psychiatric Bulletin 1999 23:644–6.Google Scholar
Steadman, H. J., Gounis, K., Dennis, D. et al. Assessing the New York City involuntary outpatient commitment pilot program. Psychiatric Services. 2001 52(3):330–6. https://doi.org/10.1176/appi.ps.52.3.330. PMID: 11239100.Google Scholar
Burns, T., Rugkåsa, J., Molodynski, A. et al. Community treatment orders for patients with psychosis (OCTET): A randomised controlled trial. The Lancet 2013 May 11;381(9878):1627–33. https://doi.org/10.1016/S0140-6736(13)60107-5. Epub 2013 Mar 26. PMID: 23537605.Google Scholar
Swartz, M. S., Swanson, J. W., Wagner, H. R. et al. Can involuntary outpatient commitment reduce hospital recidivism? Findings from a randomized trial with severely mentally ill individuals. American Journal of Psychiatry 1999 Dec;156(12):1968–75. https://doi.org/10.1176/ajp.156.12.1968. PMID: 10588412.Google Scholar
Kisely, S. and Hall, K. An updated meta-analysis of randomized controlled evidence for the effectiveness of community treatment orders. Canadian Journal of Psychiatry 2014 Oct;59(10):561–4. https://doi.org/0.1177/070674371405901010. Erratum in: Canadian Journal of Psychiatry 2017 May;62(5):357. PMID: 25565690; PMCID: PMC4197791.Google Scholar
Barnett, P., Matthews, H., Lloyd-Evans, B. et al. Compulsory community treatment to reduce readmission to hospital and increase engagement with community care in people with mental illness: A systematic review and meta-analysis. Lancet Psychiatry 2018 Dec;5(12):1013–22. https://doi.org/10.1016/S2215-0366(18)30382-1. Epub 2018 Nov 1. PMID: 30391280; PMCID: PMC6251967.Google Scholar
Burns, T., Yeeles, K., Koshiaris, C. et al. Effect of increased compulsion on readmission to hospital or disengagement from community services for patients with psychosis: Follow-up of a cohort from the OCTET trial. Lancet Psychiatry 2015 Oct;2(10):881–90. https://doi.org/10.1016/S2215-0366(15)00231-X. Epub 2015 Sep 8. PMID: 26362496.Google Scholar
Curtis, D. OCTET does not demonstrate a lack of effectiveness for community treatment orders. The Psychiatric Bulletin 2014;38(1):36–9.Google Scholar
Crawford, M. Homicide is impossible to predict. Psychiatric Bulletin 2000 24(4):152.CrossRefGoogle Scholar
Szmukler, G. (2000) Homicide inquiries. What sense do they make? Psychiatric Bulletin 2000 24:6–10.Google Scholar
University of Manchester. Five year report of the national confidential inquiry into suicide and homicide by people with mental illness. https://documents.manchester.ac.uk/display.aspx?DocID=37602 [Accessed 25.4.2022].Google Scholar
Mustafa, F. A. Notes on the use of randomised controlled trials to evaluate complex interventions: Community treatment orders as an illustrative case. Journal of Evaluation in Clinical Practice 2017; 23:185–92.Google Scholar
Segal, S. P. Assessment of outpatient commitment in randomised trials. Lancet Psychiatry 2017; 4:e26–28.Google Scholar
Mustafa, F. A. Naturalistic studies evaluating ‘real world’ OPC patients are welcome. BJPsych Bulletin 2015; 39:101.Google Scholar
Mustafa, F. Compulsory community treatment: beyond randomised controlled trials. Lancet Psychiatry 2018; 5. 10.1016/S2215-0366(18)30420-6.CrossRefGoogle ScholarPubMed
HM Government. Modernising the Mental Health Act: Increasing choice, reducing compulsion. Final report of the Independent Review of the Mental Health Act 1983, (December 2018) [online pdf]. www.gov.uk/government/publications/modernising-the-mental-health-act-final-report-from-the-independent-review [Accessed 25.4.2022]Google Scholar
Zigmond, T. Changing mental health legislation in the UK. Advances in Psychiatric Treatment 2008 14:81–3.Google Scholar
UK Parliament. Justice Committee launches inquiry into IPP sentences. 2021 [online]. https://committees.parliament.uk/committee/102/justice-committee/news/157647/justice-committee-launches-inquiry-into-ipp-sentences/ [Accessed 22.4.2022].Google Scholar
NI Direct Government Services. Indeterminate custodial sentence. [online] www.nidirect.gov.uk/articles/indeterminate-custodial-sentence [Accessed 22.4.2022].Google Scholar

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