title: Making sense of 'consent' in a constrained environment.
abstract: BACKGROUND
  This project investigates patients' and practitioners' experiences and understandings of the consent process, as it is governed by the Mental Health Act in Great Britain.
  
  
  OBJECTIVE
  We aim to illuminate our respondents' experiences of the consent process, and to explore their attempts to make sense of that process.
  
  
  METHODS
  Semi-structured interviews with 5 Responsible Medical Officers, and 7 of their consenting adult patients, were conducted at a medium-secure psychiatric hospital. We approached the analysis from the perspective of Interpretative Phenomenological Analysis.
  
  
  RESULTS
  Our analysis begins with an account of some of the common phenomenological consequences of the consent process as our participants understand them, but then moves on to discuss some of the contextual constraints which are evident from their negotiation of these understandings.
  
  
  CONCLUSIONS
  We conclude by outlining a number of emergent issues relevant to the current development of new Mental Health legislation. These include: mechanisms to allow collaboration with user groups; a more consultative role for users in their own treatment decisions; formal training and support for those conducting competency assessments; and more flexible and transparent legislative frameworks.
authors.affiliation: School of Psychology, University of Birmingham, Birmingham, B15 2TT, UK. m.larkin@bham.ac.uk
authors.forename: Michael
authors.initials: M
authors.lastname: Larkin
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Clifton
authors.forename: Richard
authors.initials: R
authors.lastname: de Visser
mesh_terms: D003142:Communication; D006801:Humans; D007258:Informed Consent; D008605:Mental Health Services / Q000331:legislation & jurisprudence*; D015279:Organizational Culture; D006113:United Kingdom