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New for old
mental health in letterpress type" width="300" height="197" />One of the features of the Mental Health Act 1983 when it was amended in 2007 was the incorporation of a set of guiding principles. By putting them in the Act it was giving a clear statement that these aren’t just matters of good practice, but should guide our way of working with the Mental Health Act at all times. These principles are then described in detail in the Act’s Code of Practice. This has recently been revised and came into operation on 1st April, with a new set of principles. In this blog I want to discuss some of the thinking behind these. Though the Mental Health Act 1983 also applies in Wales, there is a separate Code of Practice and principles in Wales (though that is being reviewed at the moment).
Modernising the principles
So why new principles? I think firstly to make them clearer to professionals in how to carry them out, and also to reflect changes that have taken place in the seven years since the last Code. There’s a lot more emphasis on the role of commissioners of mental health services, as well as providers of care. The principles are also trying to meet the requirements of more modern ways of working – such as a recovery-based approach to mental health work. The revised principles have a lot in common with the previous five, but they are listed in a different order. Whether that indicates a change in the importance is difficult to say, because the Code says they should all have equal weight.
Principles into practice
So what are the principles and what kinds of things should we be thinking about to ensure we are following them:
- The least restrictive option. Is it possible to treat the person safely without detaining them under the Mental Health Act?
- Empowerment and involvement. Can you say that you have fully involved people in decisions about their own care? Have you given people information about what is involved in their treatment? Involving people in decision making doesn’t necessarily mean doing what the person wants – it is about a collaborative approach to care.
- Respect and dignity. Are you treating the people you care for, and their carers, with respect? Is this how you would wish to be treated? There’s a lot of mention of the role of carers in the Code – and that’s a term that doesn’t get much of a mention in the Act itself.
- Purpose and effectiveness. Are you providing care and treatment that is geared to the person’s needs, and is best current practice?
- Efficiency and equity. Are you working together with other agencies to give high quality care?
The principles of the Act are just one new chapter in the Code – there are many more new chapters which I’ll discuss in future blogs. Of course, in Scotland the Mental Health (Care and Treatment) (Scotland) Act 2003 has its own Code of Practice and principles.
David Beckingham – QCS Expert Mental Health Contributor