Health care professionals must exercise restraint before revolving the hospital door, says Neil Allen
The psychiatric and legal professions are often uncomfortable bedfellows. One area of particular controversy concerns the re-admission of patients released into the community by mental health review tribunals. The detaining authorities will inevitably disagree with discharge decisions. Indeed, such is the fluctuating nature of mental disorder that episodes of acute illness following hospitalisation are not uncommon as patients react to the pressures of community life. However, due deference to clinical freedom must sometimes yield to legitimate fears over arbitrary detention. R (Care Principles Ltd) v Mental Health Review Tribunal and others [2006] EWHC 3194 (Admin) serves as a timely reminder that health care professionals must exercise restraint before revolving their hospital door.
The proceedings
Following his aggressive behaviour towards hostel staff and fellow residents, and threats to social workers, a young man with mild learning disabilities was detained in a medium-security hospital for psychiatric assessment. In the absence of a sufficient causal link between his conduct and mental disorder to justify continued detention, the tribunal deferred discharge to enable
