Service users' experiences of mental health tribunals in Ireland: a qualitative analysis.

R Murphy,K Murphy,C Mcdonald,H Felzmann,B Hallahan,M Keys,L Brosnan,E Bainbridge,A Higgins,D Mcguinness

doi:10.1017/ipm.2017.11

Abstract

To explore the mental health tribunal experiences of people admitted involuntarily under the Mental Health Act 2001. Employing a qualitative descriptive study design, data were collected from 23 service users who had experienced mental health tribunals during a recent involuntary admission. Face-to-face semi-structured interviews were conducted ~3 months post-revocation of their involuntary admission order. Data were analysed using an inductive thematic process. The majority of participants reported mixed experiences comprising positive and negative aspects in relation to information provision, emotional support and an inclusive atmosphere. Some participants reported receiving accessible information about the tribunal process, felt emotionally supported throughout, and encountered respectful and dignifying practices during the tribunal proceedings. However, many participants described experiencing non-inclusive practices, reported feeling ill-informed regarding the tribunal process, emotionally unsupported during and after the tribunal, and distressed by what they perceived as adversarial tribunal proceedings. Systemic changes could ensure that the positive experiences encountered by the minority of participants in this study are more consistently experienced. Ongoing education and training of stakeholders in the provision of inclusive tribunal practices, and the provision of accessible information and emotional support to service users through the stages of the involuntary admission process appear likely to be beneficial. Service users should automatically be offered the option of having a support person of their choosing present during tribunals.

Highlights

The Mental Health Act (MHA) 2001 (Office of the Attorney General, 2001), implemented on 1 November 2006, updated the legislative framework in Ireland within which a person with a diagnosis of ‘mental disorder’ could be admitted, detained and treated involuntarily in an approved centre
All service users who are admitted involuntarily will automatically undergo a review by a mental health tribunals (MHTs) within 21 days of their involuntary detention, unless it is revoked before the tribunal, and this automatic triggering of a MHT review is repeated for each renewal period of the involuntary admission, which can initially be for up to 3 months, for up to 6 months and for up to 12 months
Should an Admission Order be revoked prior to the MHT being held, the service user can still request that an MHT takes place to review their involuntary admission, even though the tribunal has no powers of revocation at that point

Summary

Introduction

The Mental Health Act (MHA) 2001 (Office of the Attorney General, 2001), implemented on 1 November 2006, updated the legislative framework in Ireland within which a person with a diagnosis of ‘mental disorder’ could be admitted, detained and treated involuntarily in an approved centre. All service users who are admitted involuntarily will automatically undergo a review by a MHT within 21 days of their involuntary detention, unless it is revoked before the tribunal, and this automatic triggering of a MHT review is repeated for each renewal period of the involuntary admission, which can initially be for up to 3 months, for up to 6 months and for up to 12 months. 1 week prior to the scheduled tribunal, service users are informed in writing by the MHC of the tribunal date and time, contacted by their appointed solicitor to discuss their tribunal and seen by an independent consultant psychiatrist for an assessment, who provides a report for the tribunal

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Discussion

Conclusion