LAW

Published on
R v Cannons Park Mental Health Review Tribunal ex p A (1994) - Case Notes
Focus: Interpretation of "treatability" under Section 3(2)(b) of the Mental Health Act (MHA) 1983, specifically in cases of psychopathic disorder or mental illness.
Key Issue: What constitutes "treatment" and "prevention of deterioration" for the purpose of detaining someone under the MHA 1983?
Facts:
  • Patient A: Suffered from a psychopathic disorder.
  • Proposed Treatment: Group therapy.
  • MHRT's Initial Finding: Group therapy unlikely to be effective due to A's lack of cooperation. Therefore, A was deemed untreatable but detained anyway.
  • A's Argument (Judicial Review): Treatment must alleviate or improve condition, which wasn't happening.
  • Divisional Court: Agreed with A; ordered discharge.
  • MHRT's Appeal: Argued that "treatability" has a broader meaning.
Court of Appeal Decision (Reversed Divisional Court):
  • Key Holding: The "treatability" test is satisfied if the proposed treatment is likely to prevent deterioration, even if it doesn't alleviate or improve the condition.
Principles Defined by Roch LJ:
  1. No Coercion: Detention solely to force participation in treatment is not permissible.
  2. Prevention of Deterioration: Treatment satisfies the treatability test if it's likely to prevent the patient's condition from worsening. Alleviation is not required.
  3. Eventual Alleviation/Stabilization: Treatment satisfies the treatability test if alleviation or stabilization is expected eventually.
  4. Initial Deterioration: The treatability test can still be met even if there's an initial worsening of the patient's condition (e.g., due to anger at being detained).
  5. Scope of Medical Treatment: "Medical treatment" includes nursing, care, habilitation, and rehabilitation under medical supervision.
  6. Gaining Insight/Cooperation: The treatability test is met if nursing care etc. leads to the patient gaining insight into their problem or becoming more cooperative, leading to potential long-term benefits.
Significance/Commentary:
  • Broad Interpretation of "Treatability": The court adopted a broad, pragmatic interpretation of "treatability," recognizing that preventing deterioration is a legitimate goal of treatment.
  • Focus on Long-Term Potential: Acknowledges that treatment may not have immediate positive effects, but can still be justified if it has the potential to improve the patient's condition in the long run.
  • Importance of Holistic Care: Emphasizes that "treatment" encompasses more than just direct medical interventions; it includes a range of supportive care and rehabilitation services.
  • MHA 1983, s 3(2)(b): The judgment clarifies the meaning of this section, specifically the phrase "likely to alleviate or prevent deterioration of his condition" in the context of psychopathic disorder or mental impairment.
Picture
0 Comments