Consultant psychiatrists' experiences and attitudes following the introduction of the Mental Health Act 2001: a national survey

Abstract

AbstractObjective: This study explored the attitudes and experiences of consultant psychiatrists regarding the Mental Health Act 2001.Method: A postal survey was distributed to all consultant psychiatrists (n=238) in the Republic of Ireland. All specialties were included except Child and Adolescent Psychiatry.Results: A response rate of 70% was achieved. Care of involuntarily admitted patients has improved according to 32%, but 48% found that the care of voluntary patients has deteriorated. Sixty-nine per cent of consultant psychiatrists acknowledge that involuntarily admitted patients are being changed to voluntary early to avoid a tribunal, and 21 % believe it occurs in over 40% of cases. Fourteen per cent of consultant psychiatrists have re-admitted a patient involuntarily immediately after a tribunal revoked the original Involuntary Order. Junior doctors' training by consultant psychiatrists has been reduced in 57% of placements as a result of the increased demands of the MHA 2001. Eighty-seven per cent report an increase in their on call service workload but only 23% report a sufficient increase in the number of consultants within their service. While 78% agree that patients should not be admitted involuntarily solely on the grounds that the person is suffering from a personality disorder, 58% feel that there is a risk in such patients not being involuntarily admitted in situations in which it is clinically necessary. Fifty-six per cent feel that there is a similar risk in patients with a diagnosis of substance misuse.Conclusion: Resources required to implement the Mental Health Act 2001 have not been sufficient leading to poorer quality of service and negatively affecting NCHDs training.