Independent investigation: Simeon Claxton, Petersfield, Hampshire (2004)

Future versions of the CPA policy should be more prescriptive in terms of the actions to be taken in particular events.

It would be sensible for an abbreviated version of a risk assessment to be documented even in low risk individuals to show that at least all the risks have been considered. An extended risk assessment could then be carried out … Read more It would be sensible for an abbreviated version of a risk assessment to be documented even in low risk individuals to show that at least all the risks have been considered. An extended risk assessment could then be carried out where there was evidence of risk in a particular area or individual. This form of risk assessment should continue to be used and warrants wider use in psychiatric services for the above reasons. Show less

It is recommended that consideration of section 25(a) be documented in all cases of patient’s with severe and enduring mental illness who are so detained and who have a history of disengaging.

It is recommended that discharge from section 25(a)( MHA 1983) not be undertaken by locum staff or those only involved with the patient for a brief time. There should be extensive consultation before the section is discharged.

It is recommended that all professionals be made aware of the finer points of assessing long term patients under the Act in order to prevent serious relapse.

It is recommended where patients who are severely mentally ill and under the long term care of an NHS psychiatric team that some level of communication and co-operation should be sought. Even within the NHS, psychotherapy notes may be kept … Read more It is recommended where patients who are severely mentally ill and under the long term care of an NHS psychiatric team that some level of communication and co-operation should be sought. Even within the NHS, psychotherapy notes may be kept separately from the main clinical notes and communication may be sporadic and sparse, and this should apply equally in these occasions. In the NHS, integrated notes with a section for psychotherapy would be the ideal. Where there is private therapist involvement, regular updates should be provided and details of risk shared for the safety of all parties. Show less

It is recommended that input from an AOT be considered in all cases where patients with serious mental illness start to disengage. The risk of alienation is probably small compared to the benefits of keeping patients as well as possible. … Read more It is recommended that input from an AOT be considered in all cases where patients with serious mental illness start to disengage. The risk of alienation is probably small compared to the benefits of keeping patients as well as possible. This in turn will reduce risk as these usually increase with deterioration in mental state. Show less