Key Elements of Mental Health Law Reform: A Clinical Perspective

Brendan Kelly

Mater Misericordiae University Hospital

University College Dublin

Ireland meets 80 out of 166 standards (48.2%)

Chief deficits Promoting rights

Rights of families and carers

Voluntary patients

Vulnerable groups

Economic and social rights

Capacity legislation

Arrangement-focussed view of justice

Realization-focussed view of justice

n = 81 recently detained individuals

Treatment was beneficial 78%Knew they had been detained 86%Tribunal made this easier to accept 46%Negative impact on family relationships 28%Negative impact on doctor-patient relationship 27%

n = 820 GPs

Not user-friendly 63%

Increased workload 27%

n = 321 psychiatrists

Training was satisfactory 84%Increased workload 69%Decreased time with service-users 27%Changes in relationships with service-users 41%….more legalistic, conflicted relationships

Re-define “voluntary patient”

Strengthen “best interests” dimension

Introduce cumulative tribunal “case-law”

Reduce legalism

Broaden criteria for Circuit Court appeal

…“approved mental health professionals”?

Mental capacity legislation...

Best ways to increase observance of human rights of the mentally ill:

Social policy

Mental health policy

Mental health law

Kelly BD

Penrose’s Law in Ireland: Ecological Analysis of Psychiatric Inpatients and Prisoners, 1963-2003.

Irish Medical Journal

2007; 100: 373-4

Best ways to increase observance of human rights of the mentally ill:

Social policy

Mental health policy

Mental health law

“Medicine is a social science, and politics nothing but medicine at a larger scale”

Rudolf Virchow

(1821-1902)

Key Elements of Mental Health Law Reform: A Clinical Perspective

Brendan Kelly

Mater Misericordiae University Hospital

University College Dublin

brendankelly35@gmail.com