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The purpose of this paper is to discuss and examine the implications of holding mental health tribunals in public.

The paper discusses the functioning of tribunals, compares tribunals with other legal processes in the UK and elsewhere, and reviews the legal reasoning for holding tribunal hearings in public.

The first tribunal hearing has already been held in public and another public hearing is agreed. Public hearings should allow for greater transparency and scrutiny than has thus far been possible, and may change the behaviour of attendees.

Public tribunal hearings have not yet been widely discussed in the academic literature, yet are expected to have implications for all involved.

There has been a substantial increase in the number of applications for Mental Health Review Tribunal (MHRT) hearings since they were introduced under the Mental Health Act 1983. This article discusses the implications of an apparent high level of last‐minute cancellations of scheduled hearings, often linked to the absence of independent psychiatric reports (IPRs). The author suggests a streamlined ‘one medical member review’ system would reduce the likelihood of such costly cancellations.

This paper describes the social circumstances report, written for the MHRT in an historical setting, and incorporates a small‐scale audit to determine the effect of implementing national guidelines in July 2002. Sixty reports were audited ‐ thirty in the period immediately before the introduction of national guidelines, and thirty immediately following the introduction of national guidelines. These reports concerned only patients subject to a hospital order with restriction under Section 37/41 of the Mental Health Act 1983. National guidelines comprised 102 individual sub‐headings within 17 main headings. Each report was scored using these guidelines as a checklist. Results show that compliance as measured by the national guidelines significantly improved following their circulation.Very little previous research has been undertaken in this area and only by researchers from the legal profession. Further research may need to be undertaken by social work professionals themselves, and by local authorities, which may encourage others in the profession to build on this knowledge. At present the process appears to be exclusively a legal interest rather than a joint interest with social care.

This paper aims to describe the establishment and evolution of Ireland's Mental Health Commission including its functions, strategic objectives and the challenges encountered.

This case study is based on an analysis of the outputs of the organisation to date, legislative reviews, and available evidence on the contributions of the organisation to the development of services.

The organisation has a breadth of responsibilities. It has administered reviews of 9,896 involuntary admissions to inpatient units to date since its inception. It has regulatory and enforcement powers in terms of the licensing of inpatient mental health facilities in Ireland. It has issued numerous codes of practice and rules for the guidance of those working across services. It also has an independent Inspectorate arm that inspects the quality of mental health services annually.

There is a risk of potential bias given the authors work for the organisation, however, attempts have been made to support observations with evidence from external sources.

The organisation's work has been seminal in enhancing the protection of the human rights of persons accessing mental health services. Regulatory measures have also led to changes in the behaviour of service providers, but it has proven to be more challenging to change attitudes and culture within services.

The Commission has contributed to the reform agenda by focusing greater attention on rights‐based, participatory and recovery‐oriented models of care provision.

This paper documents the work of the Mental Health Commission and highlights the impact changes have had both for those using services and those providing them.

The purpose of this article is to examine reasons given by Mental Health Review Tribunals for discharging patients from detention and the effect the length of detainment had on the immediate outcome of discharged patients and to examine the effect on outcome from quality of reports and sources of evidence presented to the MHRTs.

All documentation pertaining to MHRTs heard in the Cambridge area over a 12‐month period were reviewed.

A quarter of tribunals heard were discharged, as they did not fulfil the legal criteria for detention. RMO non‐attendance was significant in this group. Unfavourable short‐term outcomes suggest that half of these discharges were premature. Improved aftercare compliance was associated with longer duration on a Section of the Mental Health Act prior to MHRT discharge.

This study reflects practice in the service (with a relatively small number of in‐patient sections) and may not be generalisable to other populations.

Improvement in the quality of evidence including risk assessments provided at tribunals should prevent premature discharges whilst maintaining the balance between civil liberties and good clinical care.

This paper highlights the need for improvement in clinical practice and training. Whilst it is primarily of interest to doctors, all professionals involved in MHRTs can learn from it.

The paper sets out the work of the Mental Health Unit, part of the Health and Offender Partnerships Directorate. It explains the functions of the Unit in advising and taking decisions on behalf of the Home Secretary in exercising his powers in relation to dangerous mentally disordered offenders. It also sets out the work of the Unit in relation to the new Mental Health Bill. The Unit's role in developing Government policy in relation to mentally disordered offenders is not covered here.

This article aims to outline simple measures which, by making better use of existing legislation and provision, could change the day‐to‐day experience of individuals with learning disabilities currently in long stay hospitals, whilst phased local provision is being sourced for them. The proposals will also promote the safety and dignity of the minority of patients who ultimately cannot be settled successfully within their own community. Further, these measures may help ensure that any individual undergoing assessment and treatment at such a unit, for whatever period, and for whatever reason, will receive care in an environment where abuse cannot go unnoticed or unchecked.

The paper provides a review of the potential to use current legislation and provision to better effect, highlighted by case studies.

Commissioners contracting with providers could include measures to promote the safety and protection of adults with learning disabilities from abuse at little or no cost to the commissioning authority.

This is an original piece of work – developed from a short opinion/comment piece (750 words) originally prepared for the benefit of mental health lawyers in the Law Society Gazette. It is primarily of value, however, to social workers, care providers, adult safeguarding teams, advocacy services and commissioners of services.

The modernisation of mental health legislation took time in England and Wales, and resulted in an amendment to the law through the Mental Health Act 2007. The changes under way are extensive, and will affect the mental health workforce. This article outlines some of the changes and new roles, and argues that workforce changes are important features of the new legislation that confirm policy goals of integrated working and practice.

The purpose of this paper is to provide detailed assessments of the mental health laws of Ghana, South Africa, Uganda and Zambia.

The mental health laws of four countries were assessed both by country partners and staff of WHO, Geneva, using the World Health Organization (WHO) Checklist on Mental Health Legislation, which examines the level of coverage of key issues in mental health laws.

The older laws of Ghana, Uganda and Zambia do not address fundamental human rights of people with mental health conditions. South Africa's more recent Mental Health Care Act (2002) incorporates critical human rights standards, though certain provisions fail to adequately safeguard against potential violations. For mental health legislation to maintain currency with human rights standards it must be regularly reviewed and updated.

The findings highlight the urgent need to revise the mental health laws of Zambia, Uganda and Ghana, and to plan ways to address the gaps identified in the relatively new South African mental health law. The entry into force of the United Nations Convention on the Rights of Persons with Disabilities in 2008 signals a new era in how mental health legislation is to be drafted. The identification of gaps in national laws, as has been undertaken by the four countries, is an important first step towards putting in place legal frameworks to promote the rights of people with mental health conditions in line with current international human rights standards.