Sunday, January 29, 2023
Conversation about critical/relational psychiatry
Tuesday, January 24, 2023
Although it expresses concern that the introduction of conditional discharge for restricted patients may be overused, the Committee only recommends close monitoring of implementation with a statutory review after 3 years. My main concern about the report is that it does not seem to have considered the need to improve the right to an independent second opinion from a person of the patient’s choice, rather than just from a Second Opinion Approved Doctor (SOAD) appointed by the Care Quality Commission (CQC). As I said in a previous post, the strengthening of the role of SOAD is welcome, but this should be taken further by making the second opinion process even more independent. I think this is particularly the case in the context of developing the role of the Tribunal to consider treatment decisions and I would argue that eventually SOADs could be abolished.
The Committee emphasises the need for adequate resourcing of the MHA changes and sees it as essential that a detailed plan for resourcing and implementation is produced on introduction of the Bill. I look forward to seeing the government's response.
Monday, January 16, 2023
Legislating for Mental Health Act (MHA) reform
Supplementary written evidence by the Chair and Vice-Chairs of the Independent Review of the Mental Health Act helpfully highlights the need to improve the quality of advocacy services (see twitter thread; also guidance from NICE on how to commission and deliver effective advocacy services) and to enable the Mental Health Tribunal to challenge treatment decisions (see another twitter thread). NHS England expresses concern about the power of supervised discharge (see twitter thread). A letter from from the Joint Committee on Human Rights recommends improvements in MHA complaint handling (see another twitter thread).
I look forward to seeing how the Committee deals with these and other issues in its report to take forward the Mental Health Bill.
Thursday, January 12, 2023
I’ve always said it’s unrealistic to expect a paradigmatic shift in psychiatric practice because the hope of finding a biological basis for mental illness will never go away completely. But the extent to which it’s understood that this belief is wishful thinking may change. Psychiatry does need to become more open minded, more self-critical and less dogmatic in its beliefs and claims.