DOCSLIB.ORG

'Dual Diagnosis' in Learning Disability

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
'Dual Diagnosis' in Learning Disability A GENEALOGY OF ‘DUAL DIAGNOSIS’ IN LEARNING DISABILITY Joana Breda Vidal A thesis submitted in partial fulfilment of the requirements of the University of East London for the Doctoral Degree in Clinical Psychology November 2017 ABSTRACT The dual diagnosis of learning disability and mental illness stigmatises and disenfranchises those subject to it. It silences the structural and material causes of distress, pathologises natural responses to difficult circumstances and legitimises the use of restrictive methods of governance. This study used a Foucauldian genealogical approach to explore the conditions of possibility for the emergence of dual diagnosis in Britain, its attending social practices, and the subjugated discourses that could provide alternative ways of constructing and responding to the distress that people with learning disabilities may experience. Analysis of clinical and social policy documents using Rose’s (1999) six perspectival dimensions suggested that dual diagnosis emerged within a historical context of governmental concerns regarding population control, particularly in relation to economy, productivity and social order. Distal conditions of possibility included the establishment of the state’s legal and political power over insanity; the medicalisation of idiocy and lunacy; and the emergence of disciplinary and biopolitical apparatuses of the state. The developmental (re)construction of idiocy opened up a possibility for its co- occurrence with insanity and presented a conceptual framework that would be taken up following deinstitutionalisation, when dual diagnosis offered an explanation and potential solution for the social problems caused by those who did not settle into the community as desired. Dual diagnosis is neither fixed nor inevitable; it is a ‘truth’ produced by power that has been reified and endorsed through clinical and government policy and practice. Implications for clinical practice, research and policy are discussed. It is proposed that a more helpful approach to alleviating distress, poverty and disability is to address the material and social causes and the power-networks that sustain these. DEDICATIONS I would like to dedicate this work to my father, Agapito Vidal (1940-2014), a lover of history, politics and current affairs who was my ally during both challenging and mischievous times, and who always had faith that I would succeed. I would also like to dedicate this research to Professor Mark Rapley (1962- 2012), who encouraged me to pursue the topic of ‘dual diagnosis’ and introduced me to a completely new way of thinking that will shape my personal views and professional practice for years to come. ACKNOWLEDGEMENTS I would like to thank Dr Pippa Dell for her supervision, knowledge and much patience, and above all for holding hope and confidence at times of uncertainty. I would also like to thank Dr Mary Spiller, Dr Ben Hawkins and Dr Jennifer Leigh for their insightful comments and suggestions, Dr Ken Gannon and Claire Correia for their diligent guidance, and Dr Elizabeth Field and Dr Rasa Mikelyte for their generous support. I am very grateful to my mother, brother and friends for their extraordinary support, encouragement, and much needed moments of distraction. To my daughter Zara I give thanks for bearing with me, and for giving me perspective, love and laughter every single day. Most of all, I would like to thank my partner James, without whom I would not have been able to complete this work, and hope that I can return his dedication, love and kindness when the tables are turned. TABLE OF CONTENTS CHAPTER 1: INTRODUCTION .......................................................................... 1 1.1 Aims of the research ............................................................................ 1 1.2 Definitions and language ..................................................................... 2 1.3 Literature review................................................................................... 3 1.3.1 Introduction to literature review .................................................. 3 1.3.2 Search strategy ......................................................................... 4 1.3.3 The construction of the ‘problem’ of dual diagnosis ................... 5 1.3.4 The management of dual diagnosis ......................................... 11 1.3.5 Service user and carer views ................................................... 23 1.4 Rationale for study and research questions .................................... 24 CHAPTER 2: METHODOLOGY ....................................................................... 26 2.1 Epistemology ...................................................................................... 26 2.2 Genealogy ........................................................................................... 27 2.2.1 Genealogy vs traditional historiography ................................... 27 2.2.2 Analysis of ‘emergence’ and ‘descent’ ..................................... 28 2.2.3 Emphasis on power ................................................................. 29 2.3 Rationale for genealogy ..................................................................... 30 2.4 Reflexivity and ethical considerations ............................................. 31 2.4.1 Reflexivity ................................................................................ 31 2.4.2 Ethical considerations .............................................................. 32 2.4.3 Personal account ..................................................................... 32 2.5 Procedure ........................................................................................... 33 2.5.1 Doing a genealogy ................................................................... 33 2.5.2 Selecting a corpus of statements ............................................. 35 2.5.3 Tools and process of analysis ................................................. 37 CHAPTER 3: ANALYSIS AND DISCUSSION ................................................. 41 3.1 Introduction ........................................................................................ 41 3.2 Analysis of descent ............................................................................ 42 3.2.1 The creation, differentiation and governance of ‘idiocy’ and ‘lunacy’ in early English Law: De Praerogativa Regis 1324 ...... 43 3.2.2 The political power of the state over insanity ........................... 49 3.2.3 The emergence of a disciplinary apparatus of the state ............. 56 3.2.4 The medicalisation of lunacy and idiocy .......................................... 69 3.2.5 The emergence of a biopolitical apparatus of the state .............. 76 3.3 Analysis of the surface of emergence .............................................. 84 3.3.1 Emerging medical research in the co-occurrence of idiocy and insanity: Late 1800s-1950 ................................................. 84 3.3.2 The ‘tragic interlude’ ................................................................ 90 3.3.3 The emergence of the welfare state: National Health Service Act 1946 .................................................................................. 91 3.3.4 Challenges to institutional practices ........................................ 94 3.3.5 Deinstitutionalisation and community care............................... 97 3.3.6 The ‘dual diagnosis’ term ......................................................... 99 3.3.7 Transforming care? ............................................................... 102 CHAPTER 4: SUMMARY AND CONCLUSIONS ........................................... 108 4.1 Summary of findings ....................................................................... 108 4.1.1 How was dual diagnosis ‘made’ possible?............................. 108 4.1.2 What has held it in place? ...................................................... 110 4.1.3 What have been the dominant discourses and their implications? .......................................................................... 110 4.1.4 What have been the subjugated discourses and what alternative understandings might these allow? ...................... 111 4.2 Implications for Clinical Psychology .............................................. 112 4.2.1 Clinical practice: Resistance at the local level ....................... 112 4.2.2 Research: The creation and dissemination of subjugated ‘knowledge’ ............................................................................ 113 4.2.3 Policy: Political Action ............................................................ 114 4.3 Critical evaluation and reflection .................................................... 114 4.3.1 Contribution ........................................................................... 115 4.3.2 Credibility ............................................................................... 115 4.3.3 Rigour .................................................................................... 115 REFERENCES ............................................................................................... 119 APPENDICES ................................................................................................. 152 Appendix A: Bibliographical databases and search strings used ............... 152 Appendix B: Biopsychosocial factors associated with an increased risk of mental health problems in people with learning disabilities ... 153 Appendix C: Example pages from research journal ..................................
Load more

Recommended publications
  • Changing Mental Health Legislation in the UK† Tony Zigmond
    Advances in Psychiatric Treatment (2008), vol. 14, 81–83 doi: 10.1192/apt.bp.107.005116 Editorial Changing mental health legislation in the UK† Tony Zigmond Abstract Following devolution, the mental health acts of the constituent countries of the UK are diverging in their provisions. This editorial describes three significant differences between the new Mental Health (Care and Treatment) (Scotland) Act 2003, which came into effect in Scotland in 2005, and the Mental Health Act 2007 for England and Wales. Devolution, in relation to mental health law, has It has been argued that we should not have come of age. The Mental Health (Care and Treat- any separate mental health legislation and that ment) (Scotland) Act 2003 is very different both the mental capacity legislation, with perhaps from its forerunner in Scotland and from the Men- some additional safeguards, should be the basis tal Health Act 1983 for England and Wales, even as for all non-consensual treatment (Zigmond, 1998; amended by the Mental Health Act 2007. Should Szmukler & Holloway, 1998). The proposals for the report of the Bamford Review of the legislative Northern Ireland are in line with this approach. The framework in Northern Ireland (Bamford Review of College in England and Wales took the view, as had Mental Health and Learning Disability (NI), 2007) already been accepted in Scotland, that the criteria be accepted and turned into a mental health act then for determining capacity as set out in the Mental we will have a third, very distinct, piece of mental Capacity Act 2005 are too narrow for use with people health law with in the UK.
    [Show full text]
  • Developing a Capacity Test for Compulsion in Mental Health Law Chris Heginbotham1 and Mat Kinton2
    Journal of Mental Health Law May 2007 Developing a capacity test for compulsion in mental health law Chris Heginbotham1 and Mat Kinton2 Concepts of mental capacity are taking on an increased importance in the mental health law of the United Kingdom. For England and Wales, the proposal to introduce a threshold requirement of ‘impaired decision-making’ into the criteria for detention under sections 2 and 3 of the Mental Health Act 1983 was the first amendment to be voted upon in the House of Lords’ reading of the Mental Health Bill. Despite its emphatic (and whipped) resistance to this amendment, Government lost the vote by a wide margin3, although it seems possible, at the time of writing4, that the Government will seek to overturn their defeat in the Commons5. It is therefore timely to re-examine the role of such capacity tests in mental health legislation dealing with detention and treatment. This paper describes as yet unresolved definitional questions that must be encountered when concepts of mental capacity operate as a threshold for coercive psychiatric detention and/or treatment. Mental capacity tests in the Mental Health Act 1983 and other legislation In the House of Lords debate, the Minister stated that the proposal to introduce a test of impaired decision- making was “one of the core amendments that will undermine the broad intent of the Bill”6. Indeed, the clear implication of the Government’s resistance to this amendment was that the introduction of any sort of capacity-based criteria for detention would undermine the purpose of the Mental Health Act 1983 itself.
    [Show full text]
  • THE RIGHTS and WRONGS of the PSYCHOPATH in CRIMINAL LAW: HOW MODERN SCIENCE MUST RESHAPE OLD POLICY. © Jasmine Nicolson* INTROD
    THE RIGHTS AND WRONGS OF THE PSYCHOPATH IN CRIMINAL LAW: HOW MODERN SCIENCE MUST RESHAPE OLD POLICY. © Jasmine Nicolson* INTRODUCTION Psychopaths have long been enshrined in both popular culture and in law as the face of evil and danger;1 their classic characteristics of callousness, impulsivity, and remorselessness have helped to cement the conceptual link between psychopathy and violent crime.2 Psychiatrists from the 19th century, with all the equipment they had available at the time, made sweeping generalisations about the nature of the disorder. Pinel described patients who appeared without delusions or psychosis, as mentally unimpaired but engaged in impulsive acts of ‘instincte fureur’.3 Prichard built upon this definition to develop the concept of ‘moral insanity’. This term has evolved since its original intent – coming from the original French, ‘moral’ was taken to mean ‘emotional’ rather than ethical – and so the original ‘moral insanity’ was a ‘madness’ of emotional disposition and social ability, but without hallucinations or delusions.4 The concept has since evolved to include a lack of comprehension and appreciation of ethics and morality,5 but ultimately the M’Naghten rules in 1842 forged the legal defence of insanity, which required a clear presence of delusion, rather than a mere lack of morality.6 Both jurisdictions of England and Scotland have since built upon this to include an inability to 1 Cary Federman, Dave Holmes, and Jean Daniel Jacob, "Deconstructing the Psychopath: A Critical Discursive Analysis," Cultural Critique 72, no. 1 (2009). 2 Eric Silver, Edward P. Mulvey, and John Monahan, "Assessing Violence Risk among Discharged Psychiatric Patients: Toward an Ecological Approach," Law and Human Behavior 23, no.
    [Show full text]
  • Decision-Making Behaviour Under the Mental Health Act 1983 and Its Impact on Mental Health Tribunals: an English Perspective
    laws Article Decision-Making Behaviour under the Mental Health Act 1983 and Its Impact on Mental Health Tribunals: An English Perspective Nicola Glover-Thomas ID School of Law, University of Manchester, Manchester M13 9PL, UK; [email protected] Received: 21 February 2018; Accepted: 20 March 2018; Published: 24 March 2018 Abstract: In England and Wales, the Mental Health Act 1983 (MHA 1983) provides the legal framework which governs decisions made concerning the care and treatment of those suffering from mental disorders, where they may pose a risk to themselves or others. The perspective of the patient and the care provider may conflict and can be a source of tension and challenge within mental health law. Through access to a mental health tribunal, patients are offered the apparatus to review and challenge their detention. With detention rates under the mental health legislation rising exponentially, this is having a knock-on effect upon tribunal application numbers. As there is a legal requirement to review all cases of individuals detained under the MHA 1983, understanding the key drivers for this increase in detention is essential in order to understand how to better manage both detention rates and the upsurge in tribunal caseloads. With the increase in overall activity, mental health tribunal workloads present significant practical challenges and has downstream cost implications. Keywords: detention; caseload; mental health tribunal; Mental Health Act 1983; decision-making; risk; costs 1. Introduction Mental illness costs the UK economy £100 billion a year (Johnson 2016; McCrone et al. 2008). In 2012, the Her Majesty’s (HM) Government spent £126 billion on health (HM Treasury 2011, p.
    [Show full text]
  • Does Mental Health and Guardianship Legislation in Western Australia (WA
    Does mental health and guardianship legislation in Western Australia (WA) protect elderly persons from human rights abuse, and ensure procedural and substantive justice? Neville Francis Hills The University of Western Australia This thesis is presented for the degree of Doctor of Philosophy of The University of Western Australia The work presented in this thesis was performed in the Law School 2016 Thesis: Doctor of Philosophy – Mental Health Law Declaration This is to certify that this thesis does not incorporate, without acknowledgement, any material previously submitted for a degree or diploma from any university and that, to the best of my knowledge and belief, does not contain any material previously published or written by another person except where due reference is made in the text. Signed Name Neville Francis Hills Date December 1, 2016 i Thesis: Doctor of Philosophy – Mental Health Law Abstract This thesis addresses matters affecting the liberty, rights and welfare of older people in Western Australia (WA). Restriction of personal liberty to choose where to live, and who to associate with, is usually only permitted under criminal law, following legal processes. Mental health legislation also permits restraints on freedom of individuals, subject to legal oversight of the process. Admission into an aged care facility may restrict a person’s liberty, if placed in a locked area which they cannot leave without staff assistance. Laws regulating these procedures should be fair, open to scrutiny, and meeting international standards of law and good practice. In 2015 there were 16,350 Commonwealth funded aged care beds in 263 facilities in WA.
    [Show full text]
  • The Mental Health Act Code of Practice for Wales 2016
    Mental Health Act 1983 Code of Practice for Wales Review Revised 2016 Mae’r ddogfen yma hefyd ar gael yn Gymraeg. This document is also available in Welsh. © Crown copyright 2016 WG29375 Digital ISBN 978-1-4734-7176-4 Print ISBN 978-1-4734-7177-1 Contents Foreword by the Cabinet Secretary for Health, Well-being and Sport 1 Introduction 3 1 Guiding Principles 8 2 Definition of mental disorder 13 3 Human rights and reducing inequalities 15 4 Information for patients, nearest relatives, families, carers and others 17 5 Nearest relative 25 6 Independent mental health advocacy 30 7 Attorneys and deputies 40 8 Privacy, dignity and safety 42 9 Views expressed in advance 50 10 Confidentiality and information sharing 53 11 Visiting patients in hospital 57 12 The Mental Health Review Tribunal for Wales 61 13 Relationship between the Mental Health Act, the Mental Capacity Act and the Deprivation of Liberty Safeguards 67 14 Applications for detention in hospital 75 15 Emergency applications for detention 93 16 Police powers and places of safety 95 17 Transport of patients 105 18 Holding powers 111 19 Children and young people under the age of 18 116 20 People with learning disabilities or autistic spectrum disorder 128 21 People with personality disorders 135 22 Patients concerned with criminal proceedings 138 23 Appropriate medical treatment 153 24 Medical treatment 156 25 Treatments subject to special rules and procedures 168 26 Safe and therapeutic responses to challenging behaviour 183 27 Leave of absence 193 28 Absence without leave 199 29 Community
    [Show full text]
  • Continuities of Risk in the Era of the Mental Capacity Act John Fanning*
    Medical Law Review, Vol. 24, No. 3, pp. 415–433 doi:10.1093/medlaw/fww036 CONTINUITIES OF RISK IN THE ERA OF THE MENTAL CAPACITY ACT JOHN FANNING* School of Law and Social Justice, University of Liverpool, Liverpool, UK ABSTRACT When compared with the Mental Capacity Act (MCA) 2005, the Mental Health Act (MHA) 1983 seems an outlier. It authorises compulsory treatment of mental disorders on the basis of P’s risks. English law, therefore, discriminates between mental and physi- cal disorders. Following the UK’s ratification of the Convention on the Rights of Persons with Disabilities (CRPD), the MHA probably also violates international law. Against this backdrop, one might expect that decisions contingent on risk are confined to the MHA and have no relevance elsewhere. This article argues that the opposite is true: risk-based decision-making has colonised MCA processes and plays a key role in determining the nature of P’s interaction with health services. These ‘continuities’ of risk are most notable in the Deprivation of Liberty Safeguards (DOLS), where assess- ments of risk are implicitly significant for best interests and eligibility determinations. Using governmentality theory as an explanatory model, this article claims that the DOLS can be reconstructed as part of a wider legal apparatus for the regulation of the risks of harm associated with mental disorders. The article also argues that the Law Commission’s recent proposals to introduce a new ‘protective care’ scheme and expand the remit of the MHA hint at a ‘rehabilitation’ of risk as an integral component of mental health and capacity law.
    [Show full text]
  • Coercion and Consent O N M I O Topics Covered Include: Monitoring the Mental Health Act 2007–2009 M I S S
    HEALT AL H T A N C E T . M In its thirteenth and final biennial report, the Mental Health Act Commission provides data and . C observations from its monitoring of the use of the Mental Health Act between 2007 and 2009. Coercion and consent O N M I O Topics covered include: monitoring the Mental Health Act 2007–2009 M I S S UÊÌ>Êw`}ÃÊÊÌ iÊÕÃiÊvÊiÜÊ«ÜiÀÃÊvÊ-Õ«iÀÛÃi`Ê ÕÌÞÊ/Ài>ÌiÌÊÊ UÊÌ iÊvÀVLiÊÌÀi>ÌiÌÊvÊ«>ÌiÌÃÊ`iÌ>i`ÊÕ`iÀÊÌ iÊiÌ>Êi>Ì ÊVÌÊ£nÎÊÊÊ consent and Coercion The Mental Health Act Commission UÊÌ iÊiÌ>Êi>Ì ÊVÌÊ>`ÊiÌ>ÞÊ`ÃÀ`iÀi`Êvvi`iÀÃÊ Thirteenth Biennial Report 2007–2009 UÊ`>Ì>ÊÊ`i>Ì ÃÊvÊ`iÌ>i`Ê«>ÌiÌÃÊLiÌÜiiÊÓääxÊ>`ÊÓään The report also highlights several areas for future research and monitoring, and draws these to the >ÌÌiÌÊvÊÌÃÊÃÕVViÃÃÀÊL`Þ]ÊÌ iÊ >ÀiÊ+Õ>ÌÞÊ ÃÃ°Ê monitoring the Mental Health Act 2007–2009 Act Health Mental the monitoring ÛiÀÊ«VÌÕÀiÊLÞÊ Àii]Ê>Ê«>ÌiÌÊÊÌ iÊ"/Ê`i«>ÀÌiÌÊvÊ-iÛiÀ>ÃÊëÌ>]Ê V iÃÌiÀ]Ê Ê£ÇÓ°Ê ÀiiÊ >`Ê >`ÊÌÜÊiÕVÌiÃÊÊÌ iÊ£xäÃ]Ê>ÌÊ>ÊÌiÊÜ iÊ iÀÊVÃÕÌ>ÌÊ «ÃÞV >ÌÀÃÌÊVÃ`iÀi`ÊLÀ>ÊÃÕÀ}iÀÞÊÌ iÊÌÀi>ÌiÌÊvÊV ViÊvÀÊÃV â« Ài>°Ê ISBN 978-0-11-322836-2 www.tso.co.uk 9 780113 228362 5991 MHAC Cover V0 3 indd 1 424987 Mental Health21/5/09 15:52:43 13th_C The Mental Health Act Commission Coercion and consent monitoring the Mental Health Act 2007–2009 MHAC Thirteenth Biennial Report 2007–2009 Presented to Parliament pursuant to Paragraph 13 of Schedule 4 to the Health and Social Care Act 2008 (Commencement No.9, Consequential Amendments and Transitory, Transitional and Saving Provisions) Order 2009.
    [Show full text]
  • Making Decisions a Guide for People Who Work in Health and Social Care
    OPG603 Making decisions A guide for people who work in health and social care The Mental Capacity Act A guide for people who work in health and social care Making decisions A guide for people who work in health and social care Helping people who are unable to make some decisions for themselves This booklet provides introductory information on the Mental Capacity Act 2005 and how it will affect the way you work. It is not a statutory Code of Practice issued under the Mental Capacity Act 2005 and is not a guide to how the law will apply to specific situations. 1 A guide for people who work in health and social care A guide for people who work in health and social care This document has been produced by: In association with the National Care Association: 2 3 A guide for people who work in health and social care A guide for people who work in health and social care Acknowledgements The Mental Capacity Implementation Programme (MCIP) published this booklet. MCIP is a joint government programme between the Ministry of Justice, the Department of Health, the Office of the Public Guardian and the Welsh Assembly Government that was established to implement the organisation, processes and procedures to launch the Mental Capacity Act. We are very grateful to Sheila Scott, Chief Executive of the National Care Association, who wrote this booklet assisted by Zoe Sampson, Ruth Scott and Viv Shepherd. They were supported by Nadra Ahmed and Dick Barton and three focus groups. We are also very grateful to our Advisory Group which was made up of organisations who work with or represent people who work in health and social care.
    [Show full text]
  • Restricting Movement Or Depriving Liberty? Restricting Movement Or Depriving Liberty? Neil Allen1
    Restricting Movement or Depriving Liberty? Restricting Movement or Depriving Liberty? Neil Allen1 “It is of course helpful to know that the question is one of degree and the matters which should be taken into account in answering it. But one also needs to be told what the question is. What is the criterion for deciding whether someone has been deprived of liberty or not?”2 This judicial appeal for clarity exposes a jurisprudential problem which threatens one of our most fundamental human values; the right to liberty. For no-one really knows what it means to be “deprived” of one’s “liberty”. The extremities are straightforward. Prisoners are deprived; picnickers are not. But liberty deprivations may “take numerous other forms [whose] variety is being increased by developments in legal standards and in attitudes”.3 Technology, too, has played its part in such developments by introducing novel ways of restricting movement beyond the paradigmatic lock and key. The more expansive those other forms, however, the greater the risk of legal uncertainty. The challenge in this paper is one of interpretation. Article 5 of the European Convention on Human Rights 1950 protects the “liberty and security of person” which is said to have a “Council of Europe-wide meaning”.4 But how should this autonomous concept be transposed into English law? Adopting Berlin’s classic dichotomy,5 does liberty relate to the absence of external barriers or constraints, where we enjoy it to the extent that no-one is preventing us from doing whatever we might want to do (negative liberty)? Or does it concern the presence of internal factors, where we enjoy liberty to the extent that we are able to take control of our lives and self-determine in our own interests (positive liberty)?6 These complex philosophical perspectives cannot be ignored and are, to varying degrees, protected by other Convention articles.7 But article 5 is not concerned with such broad notions of liberty because it contemplates liberty in its classic sense.
    [Show full text]
  • Compiled by Linda English
    Cambridge University Press 978-1-909-72651-2 — Mental Illness, Human Rights and the Law Brendan D. Kelly Index More Information Index Compiled by Linda English admission order 17 Bentham, Jeremy 4, 6 Adults with Incapacity (Scotland) Act 2000 best interests 16, 18, 45, 57 72, 93–94 Mental Capacity Bill 2015 69–70, 74, 75, advance statements: Scotland 150, 152, 79, 86, 97, 100, 204, 215 153–155, 166 Mental Health Act 2001 120–121, 122, advocacy 123, 130, 131 ECHR 20 Mental Health (Care and Treatment) Mental Capacity Bill 2015 85–86, 98 (Scotland) Act 2003 145–146, 147–148 Mental Health Act 2007 57–58, 60, 86, Better Services for the Mentally Ill (White Paper) 199 36 Mental Health (Care and Treatment) Bill of Rights 1689: English 3–4 (Scotland) Act 2003 135, 139, 149, 155 Bill of Rights 1791: US 4 power 190, 194–195, 196, 199 Burke, Edmund 5, 6 social advocacy 214 alcohol or drugs addiction 16, 37, 48, 94–95, Cairo Declaration on Human Rights in Islam 109 11 Aristotle 2 capacity see mental capacity Ashworth Hospital 42–43 Care in the Community (DHSS) 36 Assisted Decision-Making (Capacity) Bill Chartism 5 2013 31, 70, 72, 73, 93–94, 95–96 China 192–193, 194, 198 asylums 7–8, 13, 35, 104, 181 chlorpromazine 13 asylum seekers 178 Cicero: natural law 3, 4 autonomy 211 civil partners: nearest relative 52, 59 dignity and 38, 57, 58, 61, 102, 150 Civil Partnership Act 2004 52 Ireland 122, 129, 130, 206, 207 clinical practice: rights promotion 211, Mental Health Act 2007 52–53, 56, 57, 58, 212–213 61 Clunis, Christopher 40 Northern Ireland 64, 65,
    [Show full text]
  • A SUMMARY of MENTAL HEALTH CASELAW Scott Blair, Advocate
    A SUMMARY OF MENTAL HEALTH CASELAW Scott Blair, Advocate BACKGROUND In December 2011 the Mental Heath Tribunal for Scotland (“MHTS”) published an excellent Digest of Cases covering the work of the MHTS until around the summer of 2011. The Digest was principally concerned with appeal decisions. Inspired by this I thought there might be merit in offering up a further contribution to this area. I have included cases decided since the Digest was published and have also included cases not mentioned in the Digest. For what they are worth I have offered my comments on these cases based on both my experience as an advocate in legal practice but also as a Convener of the MHTS. The MHTS has been with us for some time now and there is now a fair body of case law. This is my own contribution to a growing recognition of the need for collections of case law which are accessible and as up to date as possible in this field of Scots law. It is fair to say that the Scottish section of this paper would not have been possible but for the efforts of Valerie Mays at MHTS who led the way with the Digest which made my own task one where I was not starting from a “standing start”. The Scottish section follows a similar format to the Digest. That is deliberate. The approach taken in the Digest is excellent and makes the task of the reader an easy one. I acknowledge my profound debt to her for her earlier work. In the Scottish section, unless the context suggests otherwise, references to the Act, the 2003 Act or a Section are to be taken to be references to the Mental Health (Care and Treatment)(Scotland) Act 2003.
    [Show full text]