Bradley C, Marshall M, Gath D
Department of Psychiatry, Oxford University, Warneford Hospital.
BMJ. 1995 Feb 11;310(6976):364-7. doi: 10.1136/bmj.310.6976.364.
To determine why most patients do not exercise their right of appeal against detention under section 2 of the Mental Health Act 1983.
Part one--retrospective analysis of the clinical notes of patients detained under section 2 of the Mental Health Act. Part two-interviews with patients on the penultimate day before the deadline for lodging an appeal.
In part one, five districts in the Oxfordshire Regional Health Authority. In part two, six hospitals from three districts in the region.
In part one all patients detained under section 2 in the five districts in 1993 (n = 418). In part two interviews with 40 patients detained under section 2 in the six hospitals.
Patients were more likely to appeal if they were educated to A level standard (odds = 2.26; P = 0.0014) or had had a previous admission (2.19, P = 0.0029). Patients with a diagnosis of depression (0.31; P = 0.0.15) or dementia (0.0003, P = 0.0001) were less likely to appeal. Compared with those who appealed (n = 12) those who did not (n = 28) showed less understanding of their rights (P = 0.034) and poorer comprehension of sentences from the booklet describing patients' rights (P = 0.057). The main reasons given for not appealing were not being aware of the appeals process and being deterred by having to appeal in writing. After they received a full explanation of their rights 12 of those who did not appeal said that they wished to appeal and four did so within the time remaining before the deadline. Of 40 patients, 39 said there should be an automatic right of appeal.
The appeals procedure against detention under section 2 of the Mental Health Act is not a satisfactory way of protecting the civil liberties of patients. If patients were fully informed of their rights they would probably be much more likely to appeal.
确定为何大多数患者不行使根据1983年《精神健康法》第2条对被拘留提起上诉的权利。
第一部分——对根据《精神健康法》第2条被拘留患者的临床记录进行回顾性分析。第二部分——在上诉截止日期前倒数第二天对患者进行访谈。
第一部分在牛津郡地区卫生局的五个区。第二部分在该地区三个区的六家医院。
第一部分为1993年在五个区根据第2条被拘留的所有患者（n = 418）。第二部分为对六家医院中40名根据第2条被拘留患者的访谈。
接受过A level标准教育的患者（优势比 = 2.26；P = 0.0014）或曾有过入院治疗经历的患者（2.19，P = 0.0029）更有可能提起上诉。被诊断为抑郁症的患者（0.31；P = 0.015）或痴呆症的患者（0.0003，P = 0.0001）提起上诉的可能性较小。与提起上诉的患者（n = 12）相比，未提起上诉的患者（n = 28）对自身权利的理解较差（P = 0.034），对描述患者权利手册中句子的理解也较差（P = 0.057）。不提起上诉的主要原因是不了解上诉程序以及因必须书面上诉而受到阻碍。在收到对其权利的充分解释后，12名未提起上诉的患者表示希望上诉，其中4名在截止日期前剩余时间内提起了上诉。40名患者中有39名表示应该有自动上诉权。
针对根据《精神健康法》第2条被拘留的上诉程序并非保护患者公民自由的令人满意的方式。如果患者充分了解自己的权利，他们可能更有可能提起上诉。
