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Purpose: This paper aims to examine reform of mental health legislation in England and Wales. It covers the period from the introduction of the 1983 MHA to the proposed reforms outlined in the Wessley Review that was published in December 2018. Design/methodology/approach: This is a literature-based project. Findings: Reform of the mental health legislation reflects two potentially conflicting strands. One is the state's power to incarcerate the "mad", and the other is the move to protect the civil rights of those who are subject to such legislation. The failures to development adequately funded community-based mental health services and a series of inquiries in the 1990s led to the introduction of Community Treatment Orders in the 2007 reform of the MHA. Research limitations/implications: The development of mental health policy has seen a shift towards more coercive approaches in mental health. Practical implications: The successful reform of the MHA can only be accomplished alongside investment in community mental health services. Originality/value: The paper highlights the tensions between the factors that contribute to mental health legislation reform. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to discuss the recent National Appropriate Adult Network (NAAN) report on the role of the appropriate adult. Design/methodology/approach: This paper is based on the NAAN report and a review of relevant policy and research literature. Findings: There to Help 2 highlights that there are still significant gaps in the provision of appropriate adult schemes across England and Wales. These gaps potentially place vulnerable adults at increased risk. Originality/value: This paper is a review of recent research. [ABSTRACT FROM AUTHOR]

Purpose: The prominence of the best interests principle in the Mental Capacity Act 2005 represented an important transition to a more resolutely patient-centred model regarding decision-making for incapable adults ("P"). This paper aims to examine the courts' consideration of P's values, wishes and beliefs in the context of medical treatment, reflect on whether this has resulted in a wide interpretation of the best interests standard and consider how this impacts clinical decision makers. Design/methodology/approach: A particular focus will be on case law from the Court of Protection of England and Wales and the Supreme Court of the UK. Cases have been selected for discussion on the basis of the significance of their judgements for the field, the range of issues they illustrate and the extent of commentary and attention they have received in the literature. They are presented as a narrative review and are non-exhaustive. Findings: With respect to values, wishes and beliefs, the best interests standard's interpretation in the courts has been widely varied. Opposing tensions and thematic conflicts have emerged from this case law and were analysed from the perspective of the clinical decision maker. Originality/value: This review illustrates the complexity and gravity of decisions of the clinical decision makers and the courts have considered in the context of best interests determinations for incapacitated adults undergoing medical treatment. Subsequent to the first such case before the Supreme Court of the UK, emerging case law trends relating to capacity legislation are considered. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to "read across" a sample of domestic homicide reviews (DHRs), mental health homicide reviews (MHHRs) and adult practice reviews (APR) to identify the cross-cutting themes.Design/methodology/approach The study involved a qualitative comparative analysis of 20 Welsh reviews: 10 DHRs, 6 APRs and 4 MHHRs. Each review was triple coded by a multi-disciplinary team of researchers (representing criminology, social work and law).Findings Five overarching themes were identified from this diverse sample of cases: crossing boundaries, including transitions between services and geographical boundaries; hoodwinking, where there was manipulation of the presentation of self; faulty assessment, which was not always holistic and only based on certain aspects of behaviour; tunnel vision, resulting from the initial underpinning narrative rarely being challenged; and knowledge, with certain types being privileged over others, especially professional over that of families and para-professionals.Research limitations/implications Further research into death reviews should adopt a comparative, multi-disciplinary approach.Practical implications The research highlights the possibility for duplication across the different types of reviews. Further, it suggests that review processes could be streamlined.Originality/value Five cross-cutting themes have been developed through the very first study "reading across" three types of reviews (DHRs, APRs and MHHRs). Findings suggest the need for streamlining review processes and highlight the importance of adopting a multi-disciplinary perspective when researching death reviews. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine how the role in offender mental health for the probation service described in policy translates into practice through exploring staff and offenders' perceptions of this role in one probation trust. In particular, to examine barriers to staff performing their role and ways of overcoming them. Design/methodology/approach Qualitative secondary analysis of data from semi-structured interviews with a purposive sample of 11 probation staff and nine offenders using the constant comparative method. Findings Both staff and offenders defined probation's role as identifying and monitoring mental illness amongst offenders, facilitating access to and monitoring offenders' engagement with health services, and managing risk. Barriers to fulfilling this role included limited training, a lack of formal referral procedures/pathways between probation and health agencies, difficulties in obtaining and administering mental health treatment requirements, problems with inter-agency communication, and gaps in service provision for those with dual diagnosis and personality disorder. Strategies for improvement include improved training, developing a specialist role in probation and formalising partnership arrangements. Research limitations/implications Further research is required to explore the transferability of these findings, particularly in the light of the recent probation reforms. Originality/value This is the first paper to explore how staff and offenders perceive probation's role in offender mental health in comparison with the role set out in policy. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to explore supposed inevitable personal decline for long-term prisoners, particularly those serving a sentence of life without parole. Design/methodology/approach - Using the prison records of a life without parole sentenced prisoner. Findings - Findings suggest that prisoner deterioration is not inevitable in a whole life prison sentence. Research limitations/implications - Findings are based on one account, of a female prisoner. Practical implications - Distinct services and support are required for those with a natural life prison sentence. Originality/value - To date, there is limited research of prisoners serving life without parole, particularly the mental health implications of denying a prisoner future parole. [ABSTRACT FROM AUTHOR]

The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 within England and Wales as a framework for making decisions about incapacitated persons' care and treatment generally not amounting to a deprivation of their liberty (although such could be authorised under its powers by the new Court of Protection). From a planned date of April 2009, the MCA is to be enlarged by the provisions of the Mental Health Act 2007 (MHA 2007) to encompass deprivation of liberty, with the addition of a new framework of Deprivation of Liberty Safeguards (DOLS). The MHA 2007 also revised significant aspects of the Mental Health Act 1983 (MHA), which were implemented in November 2008. The interface between the MCA, as amended to include DOLS, and the revised MHA is complex and potentially ambiguous. This paper describes in detail some issues that may arise at the interface of the two acts, and seeks to inform professionals involved in the use of these legal frameworks of the resulting complexity. [ABSTRACT FROM AUTHOR]