HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH British Journal of Psychiatry Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

Electronic Letters to:

Original papers: Philip Shaw, Matthew Hotopf, and Anthony Davies In relative danger?: The outcome of patients discharged by their nearest relative from sections 2 and 3 of the Mental Health Act Psychiatr Bull 2003; 27: 50-54 [Abstract] [Full text] [PDF]

eLetters: Submit a response to this article

Electronic letters published:

Losing the patient or the plot?

Andrew A Al-Adwani   (4 September 2003)

Losing the patient or the plot? 4 September 2003
Andrew A Al-Adwani, Consultant Psychiatrist Department of Psychiatry, Scunthorpe General Hospital, DN15 6QL Send letter to journal: Re: Losing the patient or the plot? al-adwani{at}totalise.co.uk Andrew A Al-Adwani	Sir, The assertion by Shaw et. al.(2003) that their findings are in keeping with the findings of earlier Canadian studies is difficult to understand. The most recent of these studies, by Adams et. al. (1997), found a large and significant difference between time to readmission for those discharged by thier psychiatist vs. those discharged by panels (median 53 vs. 14 days). The Canadian studies also found a tendency to greater violence amongst those discharged through successful appeal versus those whose discharge was planned. Other seemingly large differences were found between groups but, as the authors acknowledged, these were the results of post hoc analysis. Of great interest, for instance, was the finding that patients with manic illnesses were twice as likely to have their detention revoked as compared to those with a diagnosis of schizophrenia. The most important points though are that discharge by nearest relative is quite different from discharge by tribunal and Canadian mental health legislation requires a far more stringent degree of 'proof' in order to deprive individuals of thier liberty. To make comparisons of this sort is therefore doubly confounding.