Abstract
The Mental Health Review Tribunal, established by the Mental Health Act 1959, has a very important function, in terms of civil liberties, as the forum to which persons detained against their wishes in psychiatric hospitals (or subject to a Community Treatment Order or Guardianship) can apply for an independent review of the need for that detention.Whilst there is a plethora of research into other judicial bodies, there is a notable absence of such in relation to this particular judicial forum. There has been no formal investigation of any kind into what is perceived as good or bad practice. The only research that has been carried out has mainly been by "outsiders" who have not attempted to elicit opinions from the participants as to good and bad practice but have commented, favourably or unfavourably, upon certain approaches.
This thesis addresses that deficiency in that the researcher, who has been a member of the MHRT for over 25 years and is therefore an “insider”, by undertaking enquiries amongst two of the most important groups in one region, the accredited Legal Representatives and the Lay Members, draws conclusions from empirical data rather than on an impressionistic basis. By way of semi-structured interviews with over 80% of each group, using a qualitative approach, and then analysis supported by extensive use of quotation, it will be seen there is a widespread consensus in relation to both good and bad practice.
The consensus encompasses very substantial criticisms of the approach of Medical Members and the legally qualified Chairs, the ways in which questions are ordered and information by the Medical Members is disseminated and the apparent bias of the MHRT towards the case for detention rather than, as the jurisprudence requires, a default position of discharge if not persuaded of the case for detention. The analysis is conducted within a broad frame of Natural Justice and the way in which these principles appear to be routinely disregarded by some members.
The thesis also compares those conclusions with the main findings of earlier researchers, establishes that many of their criticisms remain valid today and that there is a real concern amongst both research groups about the perceived deficiencies.
The findings of this research suggest that training and appraisal have not succeeded in eliminating what is considered bad practice and the author suggests that a collaborative reflective process might conduce towards improvement but that, in any event, principles of good and bad practice had emerged from the research and which, if heeded, would conduce towards improvement.
| Date of Award | 26 Apr 2016 |
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| Original language | English |
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| Supervisor | Phil Clements (Supervisor) |