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
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