The Mental Health Act and potential abuses

However, to understand the involuntary admittance provisions of the Mental Health Act, it must be put into the context that it is based on Judeo-Christian principles that we are all our “brother’s keeper.”

The Mental Health Act finds its philosophy in the idea that the strong is responsible for the weak and such provisions of exercising control over others for their best interests can be seen in provisions concerning the welfare of children.

However, as with all legislation which contain provisions that result in far reaching consequences of restricting a citizen’s constitutional right to freedom of movement, it is open to abuse. When one balances such restrictions it calls for a higher observance to the requirements of the Mental Health Act provisions.

While the Act provides for six ways for a person to be admitted to a psychiatric hospital, only two of the ways may be relevant to the current controversial factual matrix.

Miss Miller was either admitted to a psychiatric hospital as (a) an urgent admission patient or (b) on application of a Mental Health Officer.

To be admitted as an urgent admission patient ANY PERSON can make an allegation that the potential patient is mentally ill AND ought to be detained in the interest of his/her health and for the safety and protection of others.

To avoid detention on the basis of a misconceived or malicious allegation of mental illness the sections of the Mental Health Act require that this type of application be accompanied by a certificate from a medical practitioner and the medical certificate cannot be more than three days old.

To be admitted on application of a Mental Health Officer any person found wandering at large in a public place and who by reason of his/her appearance, conduct or conversation, a mental health officer has reason to believe is mentally ill AND in need of care and treatment in a psychiatric hospital may be taken into custody and warded for observation.

A mental health officer must have at least six months experience in the care and treatment of mentally ill persons, have experience in assisting persons to solve their social problems, a knowledge of social psychology, psychopathology and a knowledge of the mental health laws.

The reported facts that (1) a nurse conveyed Miss Miller and (2) asked before taking her

away whether the space was a “public one” can leave one with the reasonable inference that Miss Miller was admitted through an application of a mental health officer.

In regard to both means of admittance, the patient must be examined by a duly authorised medical officer within 72 hours to determine whether the patient is mentally ill AND in need of care and treatment in a hospital. Thereafter if such criteria is met the patient may be kept and treated until the medical officer is satisfied the patient is not in need of any further care and treatment.

We must also keep in mind that mental illness unlike medical illness is not that of a pure science and diagnosis of mental illness is more of an art as people may exhibit behaviours which while may be strange are not indicative of a mental illness.

Further if one is wrongly detained in any situation it is expected that there must be some form of resistance and frustration.

The current factual matrix therefore raises the following unanswered questions concerning Miss Miller:

Is/was it in the interest of her health to be detained at a mental institution; is/was she a threat to others; was her admittance accompanied by a certificate of a medical practitioner; was she wandering at large in a public place?

Did her appearance, conduct and conversation give the impression she was mentally ill; was the nurse that conveyed her a mental health officer with the requisite experience; did a duly authorised medical officer examine her within 72 hours and find that she was in need of care and treatment; what is/was she being treated for; after 16 days of treatment is she in need of further care and treatment or can she be discharged? And, the penultimate question however remains: Is Miss Miller mentally ill?

This current situation only highlights to the shock of the law abiding citizen the powerful and potential dangerous sections of some of our laws. While it is necessary in a civilised nation to protect each other through these laws we must always guard against and be ever vigilant to potential abuses.

NOTE: Daniel Khan has advised the psychiatric board on the mental health laws pertaining to involuntary admissions in regard to the homeless. On April 14, 2011 he and Minister of the People Dr Glenn Ramadharsingh delivered remarks at the monthly meeting of the Association of Psychiatrists of TT at the House of Chan, Emerald Plaza in St Augustine.


"The Mental Health Act and potential abuses"

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