Lucena Clinic, Orwell Road, Rathgar, Dublin 6, Ireland.
Int J Law Psychiatry. 2013 Jan-Feb;36(1):83-91. doi: 10.1016/j.ijlp.2012.11.011. Epub 2012 Dec 28.
The Mental Health Act 2001 (MHA 2001) was implemented in November 2006. Since that time, there has been considerable research into its impact, including the impact on service provision, use of coercive practices and the perceptions by key stakeholders. Our objective is to present a summary of research into the MHA 2001 since its implementation in the Irish state in the context of international standards and practice.
We reviewed the literature presented on Medline and Google Scholar, directly assessed relevant journals and sought abstract information from the College of Psychiatry of Ireland.
There has been a small decrease in the rate of involuntary admission since implementation but there has been no change in the representativeness of diagnoses of individuals admitted involuntarily. Mental Health Tribunals were held for 57% of those admitted involuntarily and 46% of service users found that the Mental Health Tribunal made the involuntary admission easier to accept. One year after discharge, 60% of service users reflected that their involuntary admission had been necessary. Professional groups have expressed concerns regarding workload, training time for junior doctors and paperwork.
The MHA 2001 has brought the practice of involuntary admission further into line with international standards. However, five years after the implementation of the Act international guidelines and practice have highlighted areas in need of further reform, including capacity legislation and consideration of advance directives and community treatment orders. Further research is also lacking on caregivers' or family members' perceptions of the MHA 2001.
2001 年《精神健康法》(MHA 2001)于 2006 年 11 月实施。自那时以来,已经有相当多的研究关注其影响,包括对服务提供、强制性实践的使用以及主要利益相关者的看法的影响。我们的目的是在国际标准和实践的背景下,总结自 2001 年《精神健康法》在爱尔兰实施以来的研究。
我们在 Medline 和 Google Scholar 上查阅了文献,直接评估了相关期刊,并从爱尔兰精神病学院寻求了摘要信息。
自实施以来,非自愿入院率略有下降,但非自愿入院者的诊断代表性没有变化。精神健康法庭为 57%的非自愿入院者举行了听证,46%的服务使用者认为精神健康法庭使非自愿入院更容易接受。出院一年后,60%的服务使用者认为他们的非自愿入院是必要的。专业团体对工作量、初级医生的培训时间和文书工作表示担忧。
2001 年《精神健康法》使非自愿入院的做法进一步符合国际标准。然而,该法案实施五年后,国际准则和实践强调了需要进一步改革的领域,包括能力立法以及考虑预先指示和社区治疗令。关于照顾者或家庭成员对 2001 年《精神健康法》的看法,也缺乏进一步的研究。