A conversation: challenging the relevance and wisdom of separate mental health legislation.
This paper explores the dilemmas encountered by mental health nurses when working with mental health legislation. The concerns and considerations of an expert mental health nurse, complemented by the opinion of an expert in health-care and legal issues are presented. It is argued that there is currently a distorted perception with regard to the function and sentiment of mental health legislation, and this paper aims to restore balance in interpreting and working with such law. Viewing mental health legislation primarily as a mechanism for involuntary hospitalization effectively removes any power or recourse given to mental health consumers by the law. Principles of mental health care and legislation are examined as well as the relationship the law has with dangerousness to self or others and mental ill health. A dialogue is established between the two authors to assist the exploration of these legal and clinical issues. The continued relevance of specific mental health legislation is brought into question. It is proposed that the existence of such legislation constitutes discrimination and contributes to stigma associated with mental illness. An alternative legislation for all circumstances where an individual is deemed incompetent is proposed as the most significant step towards mainstreaming of mental health care and an end to discrimination.
Wand
Timothy
T
Emergency Department, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia. twand@email.cs.nsw.gov.au
Chiarella
Mary
M
D001291:Attitude of Health Personnel; D001294:Attitude to Health; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D003220:Conflict, Psychological; D003617:Dangerous Behavior; D004509:Education, Nursing, Continuing / Q000331:legislation & jurisprudence; D006801:Humans; D007318:Inservice Training / Q000331:legislation & jurisprudence; D016743:Mental Competency / Q000331:legislation & jurisprudence; D008605:Mental Health Services / Q000331:legislation & jurisprudence*; D009517:New South Wales; D024802:Nurse's Role; D009730:Nursing Assessment / Q000331:legislation & jurisprudence; D010344:Patient Advocacy / Q000331:legislation & jurisprudence*; D011287:Prejudice; D011568:Psychiatric Nursing / Q000331:legislation & jurisprudence*; D018570:Risk Assessment / Q000331:legislation & jurisprudence; D013240:Stereotyping