The Importance Of Restraint And Seclusion Of The Mental Health Act ( 1983 )

The conclusion had is there is no one solution for all of these individual cases however the author does state “The goal is to reach a balance between the rights of the patient to treatment and the responsibility to ensure public safety. The balance between patients’ rights, the right to treatment, and public safety is taken into account with the “treatment years” approach.” (Melamed). This balance between punishment and treatment will largely depend on the severity of the crime committed, and differ from case to case. The term “treatment years” refers to the duration of time spent with medical personnel helping subdue the condition expressed by the patient before they are deemed ready to be a part of society once more. The implication of juries that are more informed on the topics of mental health and are able to view that in the context of sentencing could also benefit a suitable and more understanding sentencing of jail and treatment time. The context of murder with punishment and treatment is more difficult to find a balance with than other less severe crimes. The perpetrator has shown the ability to commit the worst crime imaginable and has demonstrated their danger to society and capability to damage lives. With this taken into account punishment for the perpetrator needs to be

Observation is one way in which mental health nurses can protect acutely mentally ill inpatients from harm and is commonly implemented for patients who impose a risk of harming themselves, others and for those who are vulnerable (Bowers et

They had gotten to be too extensive, cumbersome and the framework had opened itself up to manhandle. In 1961 the Minister of Health, Enoch Powell was welcome to talk at the AGM of the National Association for Mental Health. In his discourse he reported that it the administration of the day proposed to "the disposal of by a long shot most of the nation's mental clinics." in the meantime, territorial loads up were requested that "guarantee that no more cash than should be expected is spent on redesigning and reconditioning". This declaration had paralyzed the therapeutic callings, as there had been no sign that the legislature was going to travel in this heading; just a modest bunch of trial group care programs existed around the nation. It would

* Section 1 of the mental health act 1983 was amended in 2007. This section of the act defines a mental disorder as   'any disorder or disability of mind ' it goes on to state that a “learning disability” is define as a state of arrested or incomplete development of the mind which also includes impairment of intelligence and social functioning (MHOL, 2010).

The shutdown of state mental hospitals and lack of available financial and institutional resources force mentally ill people to the United States Judicial System for mental health. Every year thousands of people are arrested for various crimes and they are sent to jail. Sixteen percent of these people have some type of mental health problem (Public Broadcasting System , 2001). When we consider that the United States has the largest incarcerated population in the world at 2.2 million, this number is staggering (Anasseril E. Daniel, 2007). This is about 1% of the entire population of the United States. There are many reasons as to why the situation has taken such a bad turn and when the history of the treatment of mental illness is examined one can see how the situation developed into the inhumane disaster it is today.

A practice that has been put in place is the use of call buttons that are installed and easily available for the staff to use when dealing with escalating patients. Within this Veterans Affairs Hospital, the inpatient geriatric unit has at least 2-3 cases of patient-on-patient assault each month. For those that are very aggressive, this is currently being addressed by the use of one-on-one staff and antipsychotic medications. Clinicians are expected to be able to assess whether intervention is needed to protect other patients and staff from patients’ violence, to assess when patients pose a sufficient level of risk, and to assess when patients who have been hospitalized can be safely discharged to the community. However, surveys of practitioners suggest that many receive little formal training in violence risk assessment. (McNeil, et al. 2009) The limitations of formal training in risk assessment for violence suggested by such surveys underscore the need for education in this topic, hence the relevance of this educational training. Nurses on the front lines of care are ill-prepared to deal with this, hence the need for training. (Peek-Asa, et al.

A restraint is any physical or chemical measure in the healthcare setting to keep a patient from being free to move (Craven, Hirnle & Jensen, 2013). Nurses are presented with dilemmas in deciding whether to use restraints to protect the patient from falls, harming themselves or others, suppress agitation and to facilitate treatment. Improper usage and misconceptions of restraining can have negative consequences including physical and psychological issues. Physical and psychological disadvantages from restraining could include low blood pressure, decreased circulation, thrombosis, constipation, urinary incontinence, depression, fear and increased confusion (Yeh et al., 2004). Educating nurses may reduce restraint usage by increasing

Patients that we received often wants to either harm themselves or others, and these patients are also considered violent which lead to the frequent use of restraints and seclusion. Using these methods represent a danger to not only staff but also for the patients. Many injuries occur during these confrontations. The need to minimize the use of restraints and seclusion on the unit is necessary for patients and staff safety.

Horizontal violence is a hidden pattern of individual behavior in controlling other individual that risk health and safety (Hinchberger, 2009). According to Roche, Duffield and Catling-Paull, violence can be describe as emotional abuse, threat, or actual violence in any health care setting. Although the definition varies according to situations and practice settings, there is agreement that workplace violence has a negative impact on the health and wellbeing of nurses and the delivery of quality nursing care (Hinchberger, 2009). Violence mostly occur in any health care setting, However, it mostly occur in emergency department, waiting room, psychiatric ward and geriatric unit on which people involved psychological situations.

Restraints is an intervention used to confine a person to prevent injury to self or others. Different types of restraints include physical, chemical and seclusion. A physical restraint is anything that prevents the patient from being able to freely move. This can include seat belts, wrist restraints, vests, bed rails, etc. A chemical restraint is using a drug for sedation which also restricts movement or freedom. An example of a chemical restraint can be an antipsychotic. These drugs can be used to reduce anxiety, aggression, and violent behavior. Lastly, seclusion is isolating or confining the patient to a room where they cannot leave. This form of restraint is also to protect the patient from harming them self or others. The use of restraints or seclusion can be a useful intervention if all other interventions have failed. Patients should not be harmed with these restraints so it is crucial they are done properly. Patients who are put in restraints

If a person is detained under a section of the MHA then there needs to be a series of safeguards in place to ensure that any decisions are being made in relation to a persons care are in the best interests of the patient. Mental Capacity Act 2005 When providing a service to others, an individual’s rights need to be taken into consideration at all times. However, when a person is experiencing an episode of mental distress, they may not have the capacity to make some decisions that involve keeping themselves and others safe from harm, therefore requiring others to make decisions on their behalf. The Mental Capacity Act (2005) provides a statutory framework to empower and protect vulnerable people who are unable to make their own decisions (Puri et al,

The Joint Commission and Centers for Medicare and Medicaid Service (CMS) have acknowledged, “Physical restraints are considered an infringement of patient rights and a patient safety concern” (Mion, Sandhu, Khan, Ludwick, Claridge, Pile, & ... Winchell, 2010, p. 1279). These organizations have amended and aligned their regulation requirements on the use of restraints which is mainly focused on limiting its use and putting emphasis on staff education and training (Cosper, Morelock & Provine, 2015). The nursing discipline guided by these regulations should aim to improve standards of care and patient outcomes through best nursing practice. “Best practice supports individualized care that permits nursing the person safely and without physical or chemical restraint” (Cotter & Evans, 2010, p.197). The goal of this review is seek evidence to substantiate the implications of such guidelines.

Ultimately, involuntary commitment remains a complicated medically and ethically debated topic; one that creates a conflict and clear divide, between individuals who content that involuntary commitment results in vulnerable individuals with psychiatric illnesses being subjective to coercion and civil rights infringement, and those who believe, based on the principle of utility, that involuntary commitment is essential and integral to the safety of the those with psychiatric illnesses, as well as to society as a whole. Both sides offer empirical evidence, as well as moral support for why they believe involuntary commitment is either legally and morally acceptable, or ethically unacceptable, and thereby should be illegal. Regardless, infringing

The use of physical restraint is quite common among caregivers in health facilities when dealing with geriatric patients. Yet this topic is one of the most debated issues in healthcare and medicine. The purpose of medical restraints is to prevent patients from harming themselves or those around them. It seems to be a simple solution and panacea for unruly patients who needs to be treated. However, ethical implications surround its usage as the practice of physically restricting people strips them of their autonomy as well as other psychological factors, such as agitation and trauma. Therein lies the dilemma on how to approach such an issue.

The incidence of aggression and violence in acute mental health settings is internationally recognised as an ongoing and significant issue (Gascon, Martinez-Jarreta, Gonzales-Andrade, Santed, Casalod & Rueda 2009). Although the problem is endemic among mental health professionals, nurses are at a higher risk of experiencing patient or family violence compared to other healthcare providers and auxiliary staff (Schablon, Zeh, Wendeler, Peters, Wohlert, Harling & Nienhaus 2012). Evidence suggests that psychiatric nurses are two times likely to be exposed to threats of assault than medical-surgical nursing. As well, psychiatric nurses are 1.4 times more likely to be physically assaulted and 1.8 times more likely to be emotionally abused compared to nurses working in all other types of units (Hesketh et al. 2003). It is also estimated that between 25% and 80% of nurses employed in acute care hospitals experience various types of aggression (Moylan & Cullinan 2011).