23 Mar 2015 25 Apr 2017
The aim of this assignment is to focus on equal opportunities and the laws set up to protect people from discrimination on the basis of their gender, race, age and disability by providing a framework for the most vulnerable groups in society who, without legislation may feel their rights have been infringed. Prejudice and stereotyping is something we are all guilty of. From our own life experiences, beliefs and values we make assumptions about people from the way they look, speak and behave towards us. It is especially important in health care to be sensitive to the service user's requirements. Negative language and labelling can make the service user feel unworthy, intimidated and deterred from accessing the very services they require. All care providers need to ensure that they view their patients as unique individuals, promoting their individual rights and supporting them in making decisions. Language is key, if the service user cannot communicate then an advocate or interpreter is required so they do not feel discriminated against. The use of positive language can be beneficial to the service user in empowering them to make choices and have greater control over the treatment they receive.
Society has changed considerably in the last 40 years and we have become much more multi-cultural. Our attitudes and beliefs have had to change too e.g. more women in the workplace etc... The Government has introduced equality legislation to protect vulnerable groups that may otherwise have no voice. By introducing acts that protect these groups from discrimination e.g. the disabled, mentally ill and other minority groups it ensures there is a set of legal guidelines in the way people are treated and that they have equal access to the same services and rights as everyone else.
Most caring roles are governed by legislation. Older people, people with a learning disability, physical disabilities or mental health problems have service provisions, rights and other requirements laid down by the law but no overall framework for protection of abuse, except for that of children.
This part of the assignment looks at The Mental Health Act, why it was conceived, who it aims to help and its limitations in practice. The basis of the act can be traced back to 1601 when The Poor Law was created but it has come a long way since then. In 1983 The Mental Health Act was put in place to protect those suffering from a disorder or disability of the mind. In previous times those with mental health issues may have found themselves locked away from society, with no proper treatment and no guidelines on how they should be treated. It wasn't unusual for young unmarried mothers to find themselves institutionalised as society found them to be deviant and morally deficient. It wasn't until the 1959 Mental Health Act reform that it was considered wrong to punish these women, however many had already been locked away and the damage done.
The 1980's saw large-scale closures of psychiatric institutions in favour of the Governments care in the community policy, large numbers of long term patients were discharged into the community. By promoting the "least restrictive alternative" many were given freedom, the Reed Report stated "care arrangements for people with mental health problems should have proper regard to the quality of care and the needs of individuals; as far as possible, in the community, rather than in institutional settings; under conditions of no greater security than is justified by the degree of danger; so as to maximise rehabilitation and the chances of sustaining an independent life; as close as possible to their own homes and families." (Mind.co.uk,2010)
The 1983 Mental Health Act focuses on the assessment and treatment of people with mental health issues. The legislation has several sections. Each section provides guidance on dealing with specific situations that may arrive when a person has significant mental health problems. The following are some of the sections of the Act that must be adhered to;
Section 1 gives definitions of mental disorder
Section 2 describes the situations in which people can be admitted to hospital compulsorily, providing specific timeframes in which assessment must be undertaken
Section 3 describes the provisions for admission for treatment, again there are specific guidelines regarding timescales
Section 4 is regarding emergency admissions
Section 5 is about detention of a voluntary patient for a period of assessment
There are sections which deal with taking people to a place of safety and also sections relating to admissions linked to criminal behaviour. Val Michie et al,2008,(p230-231)
Sectioning a person (detaining them against their will) is part of the act that needs to be done correctly as you are denying the person their right of freedom. This can only be done if the person shows significant harm to themselves or others.
The Mental Capacity Act 2005 provides a framework to empower and protect people who are unable to make decisions themselves. By the use of advocates and health professionals any decisions they make can be supported. It enables those with mental health issues to plan ahead of time in the event that they lose mental capacity and so their wishes can be considered.
The Mental Health Bill aims to bring together and simplify the Mental Health Act 1983 and the Mental Capacity Act 2005 by making it easier to understand the rules on detention and definitions of mental disorders. Supervised community support can be put in place using a variety of health professionals to ensure access to treatment. The Bill introduces safeguards to stop people being locked away for long periods of time without being reviewed at regular intervals and denying them the right to their liberty.
The Act however does have its limitations; lack of resources, funding, low staffing levels and poor communications between agencies, vulnerable people may escape the system and cause danger to themselves and others. There have been many high profile cases of mentally ill patients slipping through the net, being released from hospital too early and not receiving the support they need.
In August 2007 Vivian Gamor was detained indefinitely under the Mental Health Act 1983 after admitting to two counts of manslaughter at the Old Bailey. Vivian had been showing increasing signs of mental illness three years prior to this, her condition deteriorated to the point where she attacked her half-sister with a knife. This led to her being sectioned under the Mental Health Act and detained in hospital where she was diagnosed as suffering from schizophrenia. Doctors felt they could control her symptoms with drugs and 28 days later she was released. Her two children had been living with their father who was unaware of the reasons for Vivian's sectioning. The children were killed on the third unsupervised visit to their mother. Antoine, 10, was beaten around the head with a hammer and then strangled while Kenniece, 3, was suffocated with cling film and her corpse stuffed into a black bin bag.
Lord laming who chaired the public inquiry into the death of Victoria Climbie said "It seems to me that had the whole range of services been directed to supporting that mother and thinking and bringing to bear all their different resources it may have been possible to prevent that mother doing what I don't imagine she ever intended to do and the children paid the ultimate price for the failure of organisations to actually carry out their duty." (BBC News, 2008)
A serious case review by the City and Hackney Local Safeguarding Children's Board was launched with its results finding a lack of communication between agencies involved in the case. Guidelines under the Children's Act obviously failed to provide the children safety and protection. Vivian had stopped taking her medication for up 10 days before the murders and was failed by the Mental Health Act as she posed a danger to herself and others. The children's father was not married to Vivian, the law stated he had no parental rights at that time and could not stop her from having access to the children.
Alan Wood, director of children's services at Hackney Council, said: "This case highlights how unpredictable mental illness can be, and the dreadful impact it can have on families. It also shows how child protection services and mental health services need to work ever more closely to successfully protect children in the future. (Communitycare.co.uk, 2008)
There have been many studies into murder associated with mental health. One published in the British Journal of Psychiatry2008 called "homicide due to mental disorder in England and Wales over 50- years", which looked at murders from 1946-2004. The researchers found that the number of murders committed by people with mental health problems had risen until the 1970's. Since then murder in the general population continued to grow, while those associated with mental health fell to very low levels. The researchers felt that the fall was due to better treatment and understanding within mental health. (The British Journal of Psychiatry, 2008)
With the introduction of the Mental Health Act 1983, figures have shown that the legislation on the whole is successful, providing more support and treatment for sufferers of mental illness. It is those cases where the system has failed that are sensationalised, creating a negative image that people with mental illness are dangerous and pose a threat to the rest of society when this has shown not to be the case.
The final part of the assignment shows how discrimination upon the individual in health care can greatly affect the way they feel about themselves and the treatment they receive. Prejudice is to prejudge, to already have an opinion or bias about a particular group of people. It is easy to assume and discriminate when an overweight person has type 2 diabetes that they have bought it on themselves, to label them as lazy and that they do not care about their own health needs. If the service user feels they are being treated this way then they can internalise those feelings and become depressed or angry. This can then lead to them feeling they are not worthy and unable to ask for or receive the help that they require. The service user is then marginalised, feeling that no-one cares leaving them isolated and vulnerable, their self-esteem suffers and the cycle of disadvantage sets in making them feel trapped in their own hopelessness, dealing with not only their medical problems but emotional ones too.
Word Count: 1444
Michie,V.Baker,L.Boys,D. and McAleavy,J.,2008.BTEC National Health & Social Care. Book 2: Cheltenham:Nelson Thornes Ltd.
BBC News.co.uk, 2008.My two children should be alive. [Online] Available at: <http://news.bbc.co.uk/1/hi/programmes/file_on_4/7201296.stm>[Accessed 19.11.2010]
Community Care.Co.UK, 2008. Hackney criticised in Vivian Gamor serious case review. [Online] Available at:<http://www.communitycare.co.uk/Articles/2008/07/17/108886/hackney-criticised-in-vivian-gamor-serious-case-review.htm>[Accessed 24.11.2010]
Mind.co.uk,2010. Dangerousness and mental health: the facts. [Online] Available at:<http://www.mind.org.uk/help/research_and_policy/dangerousness_and_mental_health_the_facts>[Accessed 19.11.2010]
The British Journal of Psychiatry, 2008. Homicide due to mental disorder in England and Wales over 50 years. [Online] Available at:<http://bjp.rcpsych.org/cgi/reprint/193/2/130>[Accessed 24.11.2010]
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