Wand Timothy, Chiarella Mary
Emergency Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
Int J Ment Health Nurs. 2006 Jun;15(2):119-27. doi: 10.1111/j.1447-0349.2006.00411.x.
This paper explores the dilemmas encountered by mental health nurses when working with mental health legislation. The concerns and considerations of an expert mental health nurse, complemented by the opinion of an expert in health-care and legal issues are presented. It is argued that there is currently a distorted perception with regard to the function and sentiment of mental health legislation, and this paper aims to restore balance in interpreting and working with such law. Viewing mental health legislation primarily as a mechanism for involuntary hospitalization effectively removes any power or recourse given to mental health consumers by the law. Principles of mental health care and legislation are examined as well as the relationship the law has with dangerousness to self or others and mental ill health. A dialogue is established between the two authors to assist the exploration of these legal and clinical issues. The continued relevance of specific mental health legislation is brought into question. It is proposed that the existence of such legislation constitutes discrimination and contributes to stigma associated with mental illness. An alternative legislation for all circumstances where an individual is deemed incompetent is proposed as the most significant step towards mainstreaming of mental health care and an end to discrimination.
本文探讨了精神科护士在依据精神卫生法开展工作时所面临的困境。文中呈现了一位精神科专家护士的关切与思考，并辅以一位医疗保健与法律问题专家的意见。有人认为，当前人们对精神卫生法的功能和意图存在扭曲的认知，本文旨在恢复对该法律进行解读和实施过程中的平衡。将精神卫生法主要视为非自愿住院治疗的一种机制，实际上剥夺了法律赋予精神卫生消费者的任何权力或救济途径。文中审视了精神卫生保健和立法的原则，以及法律与对自身或他人构成危险和精神疾病之间的关系。两位作者展开对话，以助力探讨这些法律和临床问题。特定精神卫生法的持续相关性受到质疑。有人提议，此类法律的存在构成歧视，并助长了与精神疾病相关的污名化。对于个人被判定无行为能力的所有情形，提出一项替代性立法，作为实现精神卫生保健主流化和消除歧视的最重要举措。
