Limits to the value of mental health review tribunals for offender patients. Suggestions for reform.

摘要

BACKGROUND: Reform of mental health legislation for England and Wales is due. MHRTs offer an important check in the balance between patient and public rights. AIMS: To study the quantity and outcome of MHRTs in special (high-security) hospitals. METHOD: Data were extracted from the records of 1670 patients detained under mental illness or psychopathic disorder classifications in special hospitals during 1992. RESULTS: There were 661 MHRT hearings, mostly requested by patients. Forty-three (7%) discharges were ordered, often without key data about continuing care in the written evidence. There were 56 recommendations for transfer to lesser security. Correlates of MHRT discharge were: female gender, younger age (in women), a legal classification of psychopathic disorder and shorter length of stay. Conditional discharge did not necessarily mean departure from special hospital. CONCLUSIONS: Special hospital MHRTs result in few changes in patient status. A probable need for improvement in the evidence put before an MHRT was found. Legislation reformers should consider an extension of MHRT powers to order transfer between levels of security.