Timeliness of second opinion appointed doctors' assessments of treatment plans for patients detained in medium security hospitals in London, UK. (28th November 2013)

• Record Type: Journal Article
• Authors: Murphy, Paula; Ajaz, Ali
• Is Part Of: Criminal behaviour and mental health. Volume 24:Number 3(2014)
• Page Start: 181
• Page End: 187
• Publication Date: 2013-11-28
• Subjects: Forensic psychiatry -- Periodicals; Criminal behavior -- Periodicals; Criminal psychology -- Periodicals; Criminal Psychology -- Periodicals; Dangerous Behavior -- Periodicals; Mental Disorders -- Periodicals; Comportement criminel; Criminel; Psychologie; Santé mentale; Psychiatrie médico-légale; Psychologie criminelle; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 364.305
• DOI: 10.1002/cbm.1899
• Languages: English
• ISSNs: 0957-9664

Abstract

<abstract abstract-type="main"> <title>ABSTRACT</title> <sec id="cbm1899-sec-0001" sec-type="section"> <title>Background</title> <p>Mental health legislation in England & Wales requires assessment by a second opinion appointed doctor (SOAD) to safeguard the rights of patients detained in a hospital under this law if they are either refusing certain treatments or are deemed incapable of consenting to them.</p> </sec> <sec id="cbm1899-sec-0002" sec-type="section"> <title>Aims</title> <p>Our aim was to evaluate timeliness of SOAD assessments.</p> </sec> <sec id="cbm1899-sec-0003" sec-type="section"> <title>Method</title> <p>Data were collected from the Mental Health Act administrator on all SOAD requests in 1 year for all in‐patients in two English medium security hospital units.</p> </sec> <sec id="cbm1899-sec-0004" sec-type="section"> <title>Results</title> <p>One hundred and six patients required a SOAD assessment during the 1‐year period examined, of a combined resident total of 295, as did a further 14 patients who had been discharged from hospital and were subject to a community treatment order. About half of the inpatients were seen by a SOAD within 30 days and a further quarter within 60 days, but the remaining quarter waited up to 150 days or more.</p> </sec> <sec id="cbm1899-sec-0005" sec-type="section"> <title>Discussion and implications</title> <p>These results suggest that in these trusts, unlikely to be atypical, neither patients nor clinicians are being adequately protected by legal safeguards on decisions to treat with medication (or electroconvulsive therapy) in the event of impaired competence for decisions about mental health treatments. <list id="cbm1899-list-0001" list-type="bullet"><list-item id="cbm1899-li-0001"><p>There should be clear standards for the appropriate length of time from referral to assessment by an independent doctor (SOAD).</p></list-item><list-item id="cbm1899-li-0002"><p>Compliance with standards should be transparent, so anonymised data on the matter should be routinely collected and stored by health trust Mental Health Act offices.</p></list-item><list-item id="cbm1899-li-0003"><p>Data should be monitored at agreed intervals by an independent body.</p></list-item></list> Copyright © 2013 John Wiley & Sons, Ltd.</p> </sec> </abstract>