Consultation on the draft revised Mental Health Act
1983 Code of Practice - Response from the Royal College of
Psychiatrists
The Royal College of Psychiatrists is the leading medical
authority on mental health in the United Kingdom and the Republic
of Ireland and is the professional and educational organisation for
doctors specialising in psychiatry.
The Mental Health Act Code of Practice is a crucial document for
the practice of psychiatry in England. In preparing this response
we have therefore consulted widely amongst our members. This
includes our regional Divisions, and amongst our Faculties,
Sections, and Special Interest Groups that represent the
subspecialties of Psychiatry. These include:
- Child and Adolescent Psychiatry
- General and Community Psychiatry
- Old Age Psychiatry
- Learning Disability Psychiatry
- Forensic Psychiatry
- Psychotherapy
- Rehabilitation and Social Psychiatry
- Liaison Psychiatry
Most doctors who will carry out duties under the amended Act
(such as those who are section 12 approved, or who become Approved
Clinicians) will be members of the College.
Our response is very detailed, and given the importance of the
document we make no apology for this. Most of our comments relate
to specific chapters and paragraphs and most closely to
Consultation questions 7 and 8. We have structured our response so
that it is very easy to see which chapter and paragraph the comment
relates to.
Consultation questions
1 Do you have any comments on the style and tone of the
draft Code? Do you think it is suitable for the people who will use
it?
Most of the code is appropriate in style and tone. However we
have identified some specific paragraphs and chapters where the
writing could be improved, detailed in our response to questions 7
and 8.
2 Do you have any comments on the structure of the draft
Code? Can you suggest ways in which it could be improved?
No comment.
3 Do you think that the Code has identified all the areas in
which equality is a major issue? If not, what changes would you
make?
We have identified some additional areas in regard to equality.
Please see our detailed response to individual chapters and
paragraphs under questions 7 and 8, for example see 1.4, 2, 8.3,
15.4, 16, 17.4, 18.2, 18.4, 19.4 and 21.18.
4 Is there material that the Code ought to cover that is
missing from the draft? If so, what is missing, and how should it
be addressed in the Code?
We have identified many areas where further guidance would be
helpful. This is detailed in our specific comments on the
individual chapters under questions 7 and 8, for example see
4.21-4.28, 4.28, 4.60-4.62, 6.2, 8.9, 9.18, 10.11, 11.2-11.9, 12,
13, 14.42-14.44, 19, 24, 25.43, 28, 28.19, 28.48, 35.20, 39.11,
39.33, 39.44-39.45 and 39.54.
5 Is there material in the draft Code that could be cut down
or left out completely – or covered in other guidance?
No comment.
6 What do you think of the guiding principles in the draft
Code? How could they be improved?
The use of the principles either directly in case studies or
indirectly to inform content is uneven, excellent in most chapters
but not in others. For instance Chapter 36 on Part III of the Code
does not take account of respect, patient participation, least
restrictive alternative or wishes and feelings. We appreciate that
the context for Part III patients makes a significant difference,
to varying extents, to the application of those principles but
would recommend that the Chapter be reviewed to include references
where appropriate. Chapter 30 on Aftercare should also have more
direct reference to the participation of the patient in decisions
about his or her care. Chapter 24 on treatment plans would benefit
from changes in wording to emphasise the need for the patient to
take a full part in decisions about his treatment ( this is more
fully expressed in Chapter 2 but the tone differs in that
Chapter).
Read our detailed comments