Introduction: An Overview of Patients Discharged from Mental Hospitals

Abstract

In the 1970s an important debate developed about admissions to mental hospitals: what ought to be the legal procedures involved, how were decisions made about who should or should not be admitted, who should make those decisions and so on? It had many strands: there were those such as the civil libertarians who were concerned with patients’ rights and liberties, there were others more concerned with access to resources, and still others concerned about the position of the mental hospital in society, its role, its function — and its disfunction also. Some of those critics have seen their arguments met by legislation such as the Mental Health Act 1983 in Britain, or similar such legislation elsewhere but others have not. And even then much of that legislation has been half-hearted. In Britain, for example, whilst provisions for consent to treatment have been introduced there is still no right of appeal prior to admission, nor is it clear what are and should be the rights of the patients’ relatives in the procedure for compulsory admission. Nor indeed is it clear whether there are justifications for detaining patients at all, simply because they have mental-health problems. It must be added that new criticisms have arisen, some produced by the legislation that tried to meet earlier ones: for example, the holding power granted to nurses to prevent voluntary patients from leaving hospital (under Section 5 of the Mental Health Act 1983), seems entirely unjustified, whilst the training programme for the Approved Social Workers scheme has not proved successful (see Bean, 1986 and Goodman, 1989).