Informal mental health patients: what are they told of their legal rights?

Pages51-62
Publication Date13 Mar 2017
DOIhttps://doi.org/10.1108/MHRJ-09-2016-0019
AuthorRussell Ashmore,Neil Carver
SubjectHealth & social care,Mental health
Informal mental health patients: what are
they told of their legal rights?
Russell Ashmore and Neil Carver
Abstract
Purpose The purpose of this paper is to determine what written information is given to informally admitted
patients in England and Wales regarding their legal rights in relation to freedom of movement and treatment.
Design/methodology/approach Information leaflets were obtained by a search of all National Health
Service mental health trust websites in England and health boards in Wales and via a Freedom of Information
Act 2000 request. Data were analysed using content analysis.
Findings Of the 61 organisations providing inpatient care, 27 provided written information in the form of a
leaflet. Six provided public access to the information leaflets via their website prior to admission. Although the
majority of leaflets were accurate the breadth and depth of the information varied considerably. Despite a
common legal background there was confusion and inconsistency in the use of the terms informal and
voluntary as well as inconsistency regarding freedom of movement, the right to refuse treatment and
discharge against medical advice.
Research limitations/implications The research has demonstrated the value of Freedom of Information
Act 2000 requests in obtaining data. Further research should explore the effectiveness of informing patients
of their rights from their perspective.
Practical implications Work should be undertaken to establish a consensus of good practice in this area.
Information should be consistent, accurate and understandable.
Originality/value This is the only research reporting on the availability and content of written information
given to informal patients about their legal rights.
Keywords Mental Health Act, Informal inpatient, Legal rights, Voluntary patients, Written information,
Code of practice
Paper type Research paper
Introduction
In England and Wales the Mental Health Act (Department of Health (DH), 2007) provides two
possible routes by which a person can be admitted to hospital. The person can be admitted as a
detained patient, that is; [] a patient who is detained in hospital under the Act, or who is liable
to be detained in hospital but who is (for any reason) currently out of hospital(Department of
Health (DH), 2015, p. 408; Welsh Assembly Government (WAG), 2008, p. 220, 2016a, p. 278).
A person may also be admitted to hospital as an informal patient; Someone who is being treated
for a mental disorder and is not detained under the Act(DH, 2015, p. 412; WAG, 2008, p. 222,
2016a, p. 280). A significant number of patients are admitted informally. The Health and Social
Care Information Centre (2015a, b) reported that in the period 2014-2015 there were 70,716
informal admissions to hospital (65.2 per cent of the total number of admissions). During this
period some informal admissions result in a subsequent detention under the Act, however
50,026 (46.1 per cent of the total number of admissions) of them did not.
The Act (DH, 2007) ap plies to both England and Wales, howeve r national guidanc e on its
implementation i s provided in separa te editions of the co des of practice for bot h countries.
A further complication is that these codes of practice are revised independently. The English
Code (Department of Health (DH), 2008) was revised in 2015 (DH, 2015) and the Welsh Code
(WAG, 2008) in 2016 (WAG, 2016a).
Received 22 September 2016
Revised 23 December 2016
Accepted 4 January 2017
Russell Ashmore and
Neil Carver are Senior
Lecturers (Mental Health
Nursing), both at the
Department of Nursing and
Midwifery, Sheffield Hallam
University, Sheffield, UK.
DOI 10.1108/MHRJ-09-2016-0019 VOL. 22 NO. 1 2017, pp. 51-62, © Emerald Publishing Limited, ISSN 1361-9322
j
MENTALHEALTH REVIEW JOURNAL
j
PAG E 51

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