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Title: Mental health review tribunals : the release of restricted patients
Author: Holloway, Katharine Rose
Awarding Body: University of Cambridge
Current Institution: University of Cambridge
Date of Award: 2000
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This thesis is concerned with the operation of the mental health review tribunal system and presents an empirical investigation of tribunal decision-making in restricted cases. Tribunals were first introduced in the Mental Health Act 1959 to safeguard patients from unjustified detention in hospital. In recent years mental health and social policy have become focused on issues of public safety. In the Executive Summary of a White Paper issued in 1998, the Government stated that public protection was, and would remain, its "first priority at all times". Given that the first priority of a tribunal to safeguard patients, it is important to consider how effectively tribunals are fulfilling their fundamental role in the current climate of heightened concern for public safety. Of especial concern is the operation of tribunals in restricted cases where public safety is of particular relevance. Previous research sheds little light on the issue, largely because the projects of any substantial research value are now considerably out of date. A new project, the subject of this thesis, was therefore devised to address this gap in knowledge. Focusing solely on the Trent region the project comprised three parts. First, a retrospective file study of hearings was conducted to explore the factors predictive of tribunal outcome. Five factors were found to predict the decision to discharge and four the decision to recommend transfer. The factor of greatest influence was the written opinion of the responsible medical officer. Second, a questionnaire survey of tribunal members was designed to explore how members used the evidence and applied the discharge criteria when making their decisions. The medical evidence, particularly that of the medical member, was reportedly of most assistance to the members. The evidence of the Home Secretary and the social worker were rarely of assistance to members. Questionnaire responses also indicated that a number of patients had not been discharged in spite of majority (or unanimous) agreement that they had satisfied the discharge criteria. The third study, observational in nature, yielded qualitative data that helped to guide and interpret the quantitative findings. Of note was the negative effect of a heavy caseload on the quality of tribunal decision-making.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available