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Implementation of the Mental Health Act 2007

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Title: Implementation of the Mental Health Act 2007


1
Implementation of the Mental Health Act 2007
  • Hospital Managers

2
Session 1
  • Goals and Objectives

3
Domestics
  • Emergency procedures
  • Expected finish times
  • Refreshment breaks
  • Lunch arrangements
  • Venue facilities.

4
Role of Facilitator
  • Guide you through the course
  • Maximise your participation
  • Challenge / support / advise
  • Provide information
  • Collate feedback / outcomes.

5
Ground Rules
  • Commitment
  • Courtesy
  • Honesty
  • Responsibility
  • Time keeping.

6
Objectives (1)
  • This workshop will enable you to
  • Define the processes and good practice that
    should be adopted when considering whether to
    exercise the power of discharge
  • Explain the new simplified single definition of
    mental disorder and the revised criteria for
    detention for treatment
  • Explain the provisions of supervised community
    treatment and the hospital manager's role in
    considering a patients discharge from supervised
    community treatment

7
Objectives (2)
  • Explain the role of the independent mental health
    advocate, and how this might impact of the
    running on hearings
  • Explain the changes in professional roles and the
    impact for evidence-giving in these roles
  • Explain the impact of the new duties in relation
    to Domestic Violence, Crime and Victims Act 2004
    for evidence-giving and hearings.

8
Timetable
  • Start 9.15
  • Goals and objectives
  • Mental Health Act 2007
  • Discharge of patients
  • Coffee 10.50
  • Supervised community treatment (SCT)
  • Professional roles
  • Referrals to the MRHT for Wales
  • Provisions for young people
  • Independent mental health advocacy
  • Domestic Violence, Crime and Victims Act 2004
  • Review and evaluation
  • Close 13.00

9
Session 2
  • Mental Health Act 2007

10
Why was this review necessary?
  • To help ensure that people with serious mental
    disorders receive treatment necessary to protect
    them and the public from harm
  • To simplify and modernise the definition of
    mental disorder and the criteria for detention
  • To bring mental health legislation into line with
    modern service provisions
  • To strengthen patient safeguards and tackle human
    rights incompatibilities.

11
The Mental Health Act 1983
  • Reception, care and treatment of mentally
    disordered people
  • The circumstances for detention for treatment
    without consent
  • Sets out the processes and the safeguards for
    patients
  • Main purpose is to ensure that people with
    serious mental disorders can be treated
    irrespective of their consent where it is
    necessary to prevent them from harming themselves
    or others.

12
The Mental Heath Act 2007
  • Introduced amendments to several earlier Acts
  • The Mental Health Act 1983
  • The Mental Capacity Act 2005
  • The Domestic Violence, Crime and Victims Act 2004.

13
Activity Changes to the Mental Health Act 1983
  • In pairs using the information in your
    participant pack
  • identify the significant changes to the 1983 Act,
    and
  • the impact these changes will have on your role.

14
Mental Health Act 1983 Code of Practice for Wales
  • Is designed to guide practitioners in discharging
    their powers and duties under the Mental Health
    Act
  • Chapter 27 deals with the hospital managers
    power of discharge under section 23 of the 1983
    Act.

15
Guiding principles
  • Guiding principles grouped under three broad
    headings
  • The empowerment principles
  • The equity principles
  • The effectiveness and efficiency principles

16
Activity
  • In small groups discuss …
  • What you would need to consider to ensure these
    principles are applied in practice.

17
Session 3
  • Discharge of Patients

18
Discharge of patients
  • Under the 1983 Act the hospital managers are part
    of the group (along with RC, the nearest relative
    and the MHRT for Wales) with the power of
    discharge.
  • The amendments brought in by the 2007 Act
  • do not change the exercise of this power
  • extends the power to cover a new group of
    patients.

19
Discharge of patients
  • The Act
  • Covers the discharge of community patients
    those who have been discharged onto SCT under a
    community treatment order.

20
Discharge of patients
  • Review Panels
  • Must have three or more members
  • The Act does not define either the criteria or
    the procedure for reviewing a patient's detention
  • Hospital managers should consider whether the
    criteria for admission or continued detention
    under the Act are satisfied.

21
Criteria for detention
  • The person must be suffering from a mental
    disorder of a nature or degree which makes it
    appropriate for them to receive medical treatment
    in hospital, and
  • It is necessary for their own health or safety or
    for the protection of other persons that he or
    she should receive such treatment and it cannot
    be provided unless the person is detained, and
  • Appropriate medical treatment is available for
    the person.

22
Criteria for detention
  • Main changes
  • Definition of mental disorder
  • Appropriate medical treatment.

23
Definition of mental disorder
  • The definition of mental disorder has been
    changed to 'any disorder or disability of the
    mind'
  • Replaces the previous wording of 'mental illness,
    arrested or incomplete development of mind,
    psychopathic disorder and any other disorder or
    disability of mind'
  • Abolishes the four categories of mental disorder
    that were previously used
  • This new definition provides a single, simple
    definition rather than specifying categories of
    disorder.

24
Definition of mental disorder
  • Includes clinically recognised mental illnesses
  • Encompasses forms of personality disorder
  • Disabilities of the brain would not be classified
    as mental disorders unless they give rise to a
    disability or disorder of the mind as well
  • The overall effect of this then is to widen the
    application of the provisions to all mental
    disorders.

25
Learning disability
  • In general does come under the definition of
    mental disorder
  • A person can only be detained for treatment (or
    discharged on to SCT) where it is associated with
    abnormally aggressive or seriously irresponsible
    conduct
  • No change to the previous position.

26
Exclusions
  • The 1983 Act formerly provided that
  • the definition of mental disorder should not be
    construed as implying that a person may be dealt
    with as suffering from mental disorder by reason
    only of promiscuity or other immoral conduct,
    sexual deviancy or dependence on alcohol or
    drugs.
  • Replaced with a single exclusion stating that
    'dependence on alcohol or drugs is not considered
    to be a disorder or disability of the mind'.

27
Appropriate medical treatment test
  • Needs to cover the question of
  • whether proposed medical treatment is clinically
    appropriate for the nature and degree of the
    patients mental disorder, and
  • all other factors relating to the patients
    circumstances.

28
Appropriate medical treatment test
  • Other factors to take into account
  • implications for the patient's family and social
    relationships
  • the patient's gender, gender-identity, and sexual
    orientation
  • their culture and ethnicity
  • the patients physical health
  • the consequences of not providing treatment
  • any implications for the patients education or
    work.

29
Appropriate medical treatment test
  • The criteria cannot be met unless medical
    treatment
  • is available to the patient in question
  • and is appropriate given the nature and degree of
    the patients mental disorder
  • and takes account of all other circumstances of
    the case.

30
What is meant by medical treatment?
  • The definition of medical treatment has been
    amended to read
  • Medical treatment includes nursing,
    psychological intervention and specialist mental
    health habilitation, rehabilitation and care
  • The Act now stipulates that medical treatment
  • shall be construed as a reference to medical
    treatment the purpose of which is to alleviate,
    or prevent a worsening of, the disorder or one or
    more of its symptoms or manifestations.

31
When does the appropriate treatment test apply?
  • Under section 3 of the 1983 Act, and related
    sections of Part 3
  • As part of the criteria for CTOs, which are
    covered by a new section (section 17A) of the Act
  • Used as part of the corresponding grounds for
    renewal and discharge.

32
When does the appropriate treatment test not
apply?
  • The test does not apply to
  • Section 2 or section 4 of the 1983 Act (admission
    for assessment).

33
Other criteria Patients own health and safety
  • Admission to hospital under section 3
  • Typical factors that may be taken into account
    when making such an assessment. These include
  • Any evidence suggesting that the patients mental
    health will deteriorate without treatment
  • The views of the patient on the likely course of
    the disorder and the possibility of it improving
  • The possible impact of any future deterioration
    or lack of improvement on carers, close friends,
    or family - especially those living with the
    patient
  • Whether there are other methods of coping with an
    expected deterioration or lack of improvement.

34
Other criteria Protection of other persons
  • There are two separate issues to consider
  • The nature of the potential risks
  • The likelihood of such harm occurring

Need to arrive at a balanced view of the
acceptability of the risks.
35
Discharge by hospital managers
  • The Hospital Managers
  • may undertake a review at any time at their
    discretion
  • must review a patient's detention when the RC
    submits a report under section 20(3) renewing
    detention
  • must consider holding a review when they receive
    a request from a patient
  • must consider holding a review when the RC makes
    a report under section 25(1) barring a nearest
    relatives application for the patient's
    discharge.

36
Discharge by hospital managers
  • When reviewing the case of a patient detained in
    hospital for treatment (section 3 or 37), the
    review panel should consider the following
    questions
  • Is the patient still suffering from mental
    disorder?
  • If so, is the disorder of a nature or degree
    which makes treatment in a hospital appropriate?
  • Is detention in hospital for treatment still
    necessary in the interests of the patient's
    health or safety, or for the protection of other
    people?
  • Is appropriate medical treatment available for
    the patient?

37
Discharge by hospital managers
  • Where the RC has made a report under section
    25(1) barring a nearest relatives application
    for the patient's discharge, the review panel
    should also ask
  • Would the patient, if discharged, be likely to
    act in a manner dangerous to other persons or to
    him or herself?

38
Discharge by hospital managers
  • N.B.
  • These questions should be asked in the order
    given
  • The panel must order the discharge of the patient
    unless they are satisfied, on the basis of all
    the questions asked, that continued detention is
    appropriate.

39
Activity
  • In your groups read through the case study about
    Jane and answer the questions.
  • Use the Code of Practice and information in your
    participant pack for reference.

40
Session 4
  • Supervised Community Treatment

41
Supervised community treatment (SCT)
  • SCT provides for some patients to live in the
    community while still being subject to powers
    under the 1983 Act to ensure they continue with
    the medical treatment that they need
  • The aim of SCT to break the cycle in which some
    patients leave hospital and do not continue with
    their treatment
  • SCT replaces after-care under supervision.

42
Supervised community treatment
  • An individual may be discharged onto SCT, this is
    achieved by way of a CTO
  • Only those patients who are detained in hospital
    for treatment (under section 3 or an unrestricted
    order under Part 3 of the Act) can be discharged
    onto SCT
  • In order for a patient to be eligible for SCT,
    various criteria need to be met.

43
Supervised community treatment
  • Patients who are discharged onto SCT will be
    subject to conditions whilst living in the
    community
  • Most conditions will depend on individual
    circumstances but must be for the purpose of
    ensuring the patient receives medical treatment,
    or to prevent risk of harm to the patient or
    others
  • The conditions will form part of the patient's
    CTO which is made by their RC.

44
Supervised community treatment
  • May be recalled to hospital for treatment should
    this become necessary (either in-patient or
    out-patient care)
  • May resume living in the community or,
  • If they need to be treated as an in-patient
    again, their RC may revoke the CTO
  • After-care under supervision has now been
    abolished.

45
Making a community treatment order
  • The RC and AMHP must be satisfied that the
    following five criteria are met
  • Must be suffering from mental disorder which
    makes medical treatment appropriate
  • Need medical treatment for their mental disorder
    either for their own health or safety, or for the
    protection of others
  • Must be possible to receive the treatment needed
    without having to be detained in hospital
  • Have the power for the patient to be recalled to
    hospital for treatment should this become
    appropriate
  • Appropriate medical treatment is available.

46
Making a community treatment order
  • When making decisions, the RC must consider the
    risk that the patients condition will
    deteriorate after discharge from hospital
  • In considering that risk, the RC must have regard
    to the patients history of mental disorder and
    any other relevant factors
  • If the RC and the AMHP cannot come to an
    agreement, then the CTO cannot be made.

47
Conditions of the CTO
  • There are two conditions that must appear in all
    CTOs
  • Patients must make themselves available for
    medical examinations as required for the purposes
    of determining whether the CTO should be extended
  • They must make themselves available for medical
    examinations to allow a SOAD to make a Part 4A
    certificate.

48
Conditions of the CTO
  • Further conditions will be set as required with
    the intention of
  • ensuring that the patient receives medical
    treatment, and/or
  • preventing risk of harm to the patients health
    or safety, and/or
  • protecting other persons.

49
Conditions of the CTO
  • The RC and an AMHP must agree the conditions
  • The RC may subsequently vary the conditions, or
    suspend any of them without the agreement of an
    AMHP.

50
Community treatment order
  • How long does the CTO last for?
  • May initially last for up to six months from the
    date when the order was made
  • Can then be extended for a further six months
    and, following that, it can be extended for
    periods of one year at a time
  • To be extended, the RC must examine the patient
    and provide a report to the hospital managers
    confirming that the necessary criteria are met
  • An AMHP must agree that the criteria for
    extension of the CTO are satisfied, and that it
    is appropriate to extend the CTO, before the
    report can be made.

51
Community treatment order
  • A CTO comes to an end if
  • the period of the CTO runs out and the CTO is not
    extended, or
  • the patient is discharged from the applicable
    powers of the 1983 Act, or
  • the RC revokes the CTO following the patient's
    recall to hospital.

52
Recall to hospital
  • A community patient may be recalled temporarily
    to hospital if the RC decides
  • that the patient needs to receive treatment for
    his or her mental disorder in a hospital, and
  • that without this treatment there would be a risk
    of harm to the patients health or safety, or to
    other people.
  • Both conditions must be met.

53
Recall to hospital
  • If the criteria for recall are met, the patient
    can also be recalled
  • even if the they are complying with the
    conditions set out in the CTO
  • if they fail to comply with the condition that
    they must make themselves available for
    examination.

54
Revocation of the CTO
  • The RC may revoke the patients CTO if the
    patient meets the normal criteria for detention
    for treatment in hospital
  • This will require an AMHPs agreement that it is
    appropriate to do so
  • The authority to detain the patient is revived
    (unless the patient is a Part 3 patient)
  • Considered a new period of detention and the
    patient has the normal rights of appeal.

55
Expiry of a CTO
  • A community patient will be discharged absolutely
    from liability to recall on the expiry of the
    CTO, if the order has not previously ceased to be
    in force.

56
Discharge from SCT
  • Orders for discharge
  • Under section 23 of the Act, the patient can be
    discharged from SCT in the following ways
  • by the RC at any time
  • by the hospital managers, using their powers of
    discharge
  • by the hospital managers following application by
    the patients nearest relative giving not less
    than 72 hours notice (Part 2 patients only).

57
Discharge from SCT
Restriction on discharge of community patients by
a nearest relative
  • The nearest relative must give 72 hours notice in
    writing to the hospital managers if they wish to
    make such an order
  • The RC can bar the order for discharge from
    taking effect, using their powers under section
    25(1), by making a report that certifies that the
    patient is likely to act in a dangerous manner to
    themselves or others if discharged from SCT.

58
Discharge by hospital managers using powers under
section 23
  • Reviewing SCT
  • The Hospital Managers
  • may undertake a review of the patient's case at
    any time at their discretion
  • must review a patient's case when the RC submits
    a report under section 20(3) renewing CTO
  • should consider holding a review when they
    receive a request from a patient
  • should consider holding a review when the RC
    makes a report under section 25(1) barring a NR's
    application for the patients discharge.

59
Discharge by hospital managers using powers under
section 23
  • Where a patient is subject to SCT, the hospital
    review panel should consider the following
    questions
  • Is the patient still suffering from mental
    disorder?
  • If so, is the disorder of a nature or degree
    which makes appropriate for them to receive
    medical treatment?
  • If so, is it necessary in the interest of
    patients health and safety or for the protection
    of other people?
  • Can such treatment be provided without being
    detained in hospital but subject to being liable
    to recall?
  • Is appropriate medical treatment available for
    the patient?

60
Discharge by hospital managers using powers under
section 23
  • These should be considered in the order given
  • Unless satisfied that all these questions can be
    answered positively, the panel should direct the
    discharge of the patient.

61
Discharge by hospital managers using powers under
section 23
  • Where the RC has made a report barring discharge
    by the nearest relative, the hospital managers
    should also consider the following question
  • If discharged, would the patient be likely to act
    in a manner dangerous to other persons or to him
    or herself?
  • If, on consideration of the report and other
    evidence, the Hospital Managers disagree with the
    RC and decide the answer to this question is
    "no",
  • they should discharge the patient.

62
Activity
  • In your groups read through the case study about
    John and answer the questions.
  • Use the Code of Practice and information in your
    participant pack for reference.

63
Session 5
  • Professional roles

64
Professional roles
  • The 2007 Act has
  • broadened the group of practitioners who can take
    on the roles which are central to the operation
    of the 1983 Act
  • it replaces the role of the responsible medical
    officer (RMO) with that of the responsible
    clinician (RC)
  • it replaces the role of the approved social
    worker' (ASW) with that of the approved mental
    health professional' (AMHP).

65
Professional roles Approved Clinician
  • The criteria set out in the 'Directions' for a
    person to be 'approved' are that
  • they fulfil the professional requirements
  • they are able to demonstrate that they possess
    the relevant competencies, and
  • they have completed within the last two years a
    course for the initial training of ACs.

66
Professional roles Approved Clinicians
  • To fulfil the professional requirements, a person
    must be one of
  • a registered medical practitioner
  • a chartered psychologist
  • a first level nurse whose field of practice is
    mental health or learning disabilities nursing
  • an occupational therapist
  • a registered social worker.

67
Professional roles Approved Clinicians
  • Responsibilities under Part 2 of the Act
  • The RC has taken over the duties previously
    fulfilled by the RMO
  • The RC has also taken on a similar role in
    respect of SCT
  • Where the patient is liable to be detained or a
    community patient, the RC is defined as the AC
    with overall responsibility for the patient's
    case
  • Where the patient is subject to guardianship, the
    RC is defined as the AC authorised by the
    responsible Local Social Services Authority to
    act.

68
Professional roles Approved Clinicians
  • Responsibilities under Part 3 of the Act
  • Where a patient is concerned in criminal
    proceedings, the RC has again taken over the
    duties previously fulfilled by the RMO
  • Certain functions previously restricted to
    registered medical practitioners can now be
    exercised also by ACs.

69
Professional roles Responsible Clinician
  • The RC may be any practitioner who has been
    approved for that purpose - i.e. an approved
    clinician (AC)
  • Not restricted to medical practitioners. May be
    undertaken by practitioners from other
    professions, such as nursing, psychology,
    occupational therapy and social work.
  • The functions that RCs have taken over from RMOs
    have been supplemented by new functions in
    relation to SCT.

70
Professional roles Approved Mental Health
Professionals
  • Functions of the AMHP
  • The AMHP has taken over the duties and functions
    of the ASW
  • making applications for admission and detention
    in hospital under Part 2 of the 1983 Act
  • making applications for guardianship
  • new functions in relation to SCT
  • LSSAs have a duty to arrange for an AMHP to
    consider the patient's case on their behalf.

71
Professional roles Approved Mental Health
Professionals
  • Who may be an AMHP?
  • Social workers
  • A wider group of professionals that they have the
    right skills, experience and training
  • There is no requirement that an AMHP be an
    employee of an LSSA.

72
Professional roles Approved Mental Health
Professionals
  • How is an AMHP 'approved'?
  • LSSAs will approve AMHPs
  • Before doing so they must be satisfied that the
    individual
  • has appropriate competence in dealing with
    persons who are suffering from mental disorder,
    and
  • Meets requirements set out in Regulations setting
    out conditions for approval, factors as to
    competency and requirements for training
  • The Care Council for Wales must approve courses
    for the training of AMHPs in Wales, regardless of
    the trainees' profession.

73
Professional roles Approved Mental Health
Professionals
  • To fulfil the professional requirements set out
    in the Regulations, a person must be one of
  • a registered social worker
  • a chartered psychologist
  • a first level nurse whose field of practice is
    mental health or learning disabilities nursing
  • an occupational therapist.

74
Session 6
  • Referrals to the Mental Health Review Tribunal
    for Wales by Hospital Managers

75
The Mental Health Review Tribunal
  • The MHRT for Wales reviews a patient's case on
  • application from the patient or the patient's
    nearest relative
  • referral by hospital managers if the MHRT for
    Wales has not reviewed the case within a given
    period
  • referral from the Welsh Ministers (in
    non-restricted cases)
  • referral from the Secretary of State for Justice
    (restricted cases).

76
Patients for whom Hospital Managers must make a
referral
  • Patients admitted to a hospital in pursuance of
    an application for admission for assessment
  • Patients admitted to a hospital in pursuance of
    an application for admission for treatment
  • Community patients
  • Patients whose CTO is revoked
  • Patients transferred from guardianship to a
    hospital.

77
Periods after which hospital managers must make a
referral
  • Six months after detention from the day on which
  • the patient was first detained for assessment
    (under section 2) or for treatment (under section
    3), or
  • The patient is admitted following revocation of a
    CTO, or
  • the patient was detained in hospital following a
    transfer from guardianship
  • After 3 years without review (or one year for
    patients aged under 18 years) and the MHRT for
    Wales has not reviewed the case in that time.

78
Key changes
  • Hospital managers were only under a duty to make
    a referral to the MHRT for Wales upon the renewal
    of patient's detention
  • The requirement to refer a patient aged under 18
    years after one year represents an extension to
    the previous age limit of 16 years.

79
Following revocation of CTO
  • The RC may recall the patient to hospital where
    appropriate
  • The RC may revoke the patient's CTO. This will
    require an AMHP's agreement that it is
    appropriate
  • The managers of the hospital have a statutory
    duty to refer the patient's case to the MHRT for
    Wales as soon as possible after the order is
    revoked.

80
Session 7
  • Provisions for Young People

81
Informal admission of patients aged 16 or 17 with
the capacity to consent
  • Decisions cannot be overridden by a person with
    parental responsibility for them
  • This means that
  • If the patient consents, they can be admitted to
    hospital and their consent cannot be overridden
    by a person with parental responsibility
  • If the patient does not consent, they cannot be
    informally admitted on the basis of consent from
    a person with parental responsibility
  • The young person could nevertheless be admitted
    to hospital for compulsory treatment if they meet
    the relevant criteria.

82
Accommodation for patients aged under 18
  • Hospital managers are under a duty to
  • Ensure that, subject to their needs, patients
    under 18 are accommodated in an environment that
    is suitable for their age.

83
Accommodation for patients aged under 18
  • The decision should be taken on the basis of
  • What is suitable for a patient of this age?
  • Is there something about this patient or the
    circumstances that suggests the use of an
    environment that would not normally be suitable
    for a patient of this age?
  • Consultation with a suitable person with
    experience in child and adolescent mental health
    services cases.

84
Session 8
  • Independent Mental Health Advocates

85
Qualifying patients
  • Patients who qualify for advocacy support are
    essentially those who are
  • liable to be detained under the Act (excluding
    those subject to sections 4, 5(2), 5(4), 135 or
    136), or
  • subject to guardianship, or
  • a community patient
  • informal patients being considered for section 57
    or 58A treatments
  • Qualifying patients must be informed that they
    are eligible for the services provided by an IMHA
    as soon as is practicable
  • An IMHA will meet with a patient on the request
    of the patient, the nearest relative, the RC or
    an AMHP.

86
How does the IMHA support the patient?
  • Includes help in obtaining information about and
    understanding
  • the provisions under which the patient qualifies
    for an IMHA
  • any conditions or restrictions to which affect
    the patient
  • the medical treatment the patient is receiving or
    is being proposed or discussed
  • the legal authority for providing the treatment
  • the requirements of the Act which apply to
    treatment.

87
How does the IMHA support the patient?
  • The IMHA may also
  • support the patient to exercise their rights
    under the Act, including by representing them
  • support to ensure they can participate in
    decisions about care and .

88
Independent mental health advocates
  • IMHA has a right to
  • access any hospital or local authority records
    relating to the patient (with patient consent)
  • meet patients in private and to visit and
    interview anyone professionally concerned with
    the patients medical treatment
  • It is important to note also that the hospital
    managers cannot withhold correspondence between
    patients and their advocates.

89
Independent mental health advocates
  • Who can act as an IMHA?
  • Must be approved by the Local Health Board or are
    employed by a provider of advocacy services to
    act as an IMHA.
  • Before approving any person as an IMHA a Local
    Health Board must be satisfied that the person
  • has appropriate experience or training
  • is of integrity and good character
  • will act independently of any person who
    instructs them to act as an IMHA or is
    professionally concerned with the medical
    treatment of the qualifying patient.

90
Activity Hospital manager hearings
  • In pairs using the information in your
    participant pack
  • identify the likely impact of these changes on
    your role
  • what you will need to consider.

91
Hospital manager hearings
  • Expect to see IMHAs supporting patients at such
    hearings
  • Hospital managers will need to consider
  • Whether you will take evidence at the hearing
  • How you will respond if the patient wishes to
    speak without professionals present.

92
Session 9
  • Domestic Violence, Crime and Victims Act 2004

93
Domestic Violence, Crime and Victims Act 2004
  • Will apply where
  • the offender is made subject to a hospital order
    without restrictions, or
  • the offender is made subject to a hospital and
    limitation direction and the limitation direction
    subsequently ceases to have effect, or
  • the offender is transferred from prison to
    hospital under a transfer direction without a
    restriction direction, or where the restriction
    direction is removed.

94
Victims rights
Right to make representations and receive
information
  • The local probation board must establish whether
    the victim wishes
  • to make representations as to whether the patient
    should be subject to conditions in the event of
    discharge from hospital
  • to receive information about those conditions in
    the event of the patients discharge

95
Domestic Violence, Crime and Victims Act 2004
  • The Hospital Managers must
  • inform the victim if the offender is being
    considered for discharge or is to be discharged
  • inform the victim whether the patient is to be
    subject to a CTO including any conditions.

96
Session 10
  • Review, Action Planning and Evaluation

97
Review and action planning
  • Review of your issues and goals
  • Review of course objectives.

98
Course objectives
  • Do you now feel able to
  • Define the processes and good practice that
    should be adopted when considering whether to
    exercise the power of discharge
  • Explain the new simplified single definition of
    mental disorder and the revised criteria for
    detention for treatment
  • Explain the provisions of supervised community
    treatment and the hospital manager's role in
    considering a patients discharge from supervised
    community treatment

99
Course objectives
  • Explain the role of the independent mental health
    advocate, and how this might impact of the
    running on hearings
  • Explain the changes in professional roles and the
    impact for evidence-giving in these roles
  • Explain the impact of the new duties in relation
    to Domestic Violence, Crime and Victims Act 2004
    for evidence-giving and hearings.

100
Review and action planning
  • Complete your action plan.

101
Evaluation
  • Please complete the course evaluation form.
  • Thank you.
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