Impact of Mental Health Legislation on People with Dementia (Research Paper Sample)

Impact of Mental Health Legislation on People with Dementia Author Institution Impact of Mental Health Legislation on People with Dementia Introduction Dementia is defined as the loss of one’s memory of current and past relations and events that happens progressively (Bynum, 2014). On the other hand, the Australian government defines mental illness as a condition "characterized by a disturbance of thought, mood, volition, perception, orientation or memory”, which affects the behavior or judgment of a person permanently or temporarily (Government of Western Australia, 2016). This definition includes the characteristics that define dementia. Thus, dementia is viewed as a mental illness (Bynum, 2014; Emmett, Poole, Bond, & Hughes, 2013; Malhotra & Shah, 2015). Obtaining treatment for mental disorders such as dementia is essential. The manner in which such persons have to be treated has also been a topic of debate over time thereby calling for legislation to regulate the conduct of professionals when providing health care (Livingston et al., 2010). The nature of their vulnerability also provokes legislation to come to their aid especially in regulating decision-making done on their behalf. In most instances, legislation usually allows for the admission, detainment, and treatment of persons with mental disorders (Szmukler, Daw & Callard, 2014). The bone of contention is the point at which an individual is considered to have lost his or her capacity to make decisions on his or her own behalf. Certain legislation, for instance UK and Australia, considers an individual to have lacked capacity when the same individual is unable, to express his decision, consider and utilize information to facilitate decisions, understand and retain information relevant to decisions (Ryan, Callaghan & Large, 2012). Different reasons have also been brought forward to explain why individuals may lack the capacity to make decisions on their own behalf. Dementia has been acknowledged as one of the major causes for lack of capacity. Other causes include learning disability and brain injury among others (Livingston et al., 2010). Legislation on mental health may be formulated from different aspects, which may include but not limited to decisions about health care and treatment, identification and detention, equality in treatment, use of coercive means, and human rights among others. Legislations, in most cases, are formulated to curb emerging issues in the psychiatric domain with regard to dementia patients to benefit and protect them before, during, and after care has been provided (Szmukler, Daw & Callard, 2014). On the other hand, the formulated legislation may be accompanied by several challenges directed to professionals, relatives and friends, and mental health institutions taking care of such patients (Livingston et al., 2010). This review of previous studies therefore seeks to examine the impacts of mental health legislation, in Australia, England, and United States, with the view of analyzing the benefits and challenges accruing from various aspects of mental health legislation and their possible direct and indirect effects on persons with dementia. Literature search This paper followed a systematic search of literature process to identify scholarly literature on the impact of mental health legislation on people with dementia. A search was carried out through different databases and journals for peer-reviewed papers. The search was done to filter papers that were published between the year 2009 and 2016. From the PubMed.gov database, the search string used MeSH terms "dementia”, "legislation”, "mental health”, and "persons”. This search resulted in a total of twenty-four articles. A filter was instigated to remain with articles that had both the terms ‘’dementia’ and ‘legislation’ ending up with two articles. A second search was carried out using the search string "mental health legislation on people with dementia" on Biomed Central database. This search resulted in one hundred and thirteen articles. The abstracts were retrieved and read, which lead to retaining three articles for this review. A third search was conducted in the Wiley online library database with the search string "impact of mental health legislation on people with dementia" that resulted in twenty-five results. After retrieving and reading through the abstracts, two articles were retained for this review. The last search was carried out in the Google Scholar database through HINARI with the search string "impact of mental health legislation on people with dementia" resulting in the retaining of six articles, after retrieval of relevant abstracts. The second search on Google Scholar used the search string "mental health legislation on people with dementia Australia”, with Exact "Mental Health Act" resulting in thirteen articles. The abstracts were retrieved and studied, which resulted in retaining six articles for the review. The Mental Health Act 2014 for Australia was also retrieved and used in this review. Thus, the total number of article in the review is twenty. Benefits of mental health legislation on individuals with dementia The principles entrenched in legislation targeting the mental disorder provide significant avenues for reforming the psychiatric practice and further providing worthwhile directions to appointed decision makers. These contributions promote patients’ interests and direct decisions. Several principles have been suggested for the latter courses. The first principle as envisaged in the Western Australia mental health legislation ensures that all the decisions made on behalf of the individuals with dementia are done in a manner that significantly minimizes the undesired impacts of mental disorder (Government of Western Australia, 2016). This criterion seeks to curb adverse decisions that may hinder patients’ recovery. This norm is referred to as the principle of purpose (Glover-Thomas, 2013; Callaghan & Ryan, 2012). In as much as legislation may seek to act based on the best interest of the dementia patients (Government of Western Australia, 2016), skewed application of mental health legislation may lead to social deprivation. Consequently, a significant positive correlation was found between relative deprivation and use of acute community care provisions of New Zealand legislation on mental health (O’Brien, Kydd & Frampton, 2011). The second principle in the Western Australian mental health legislation seeks to restrict the decision makers’ powers with regard to setting restrictions on patients’ liberty. In this case, restrictions imposed on dementia patients’ by decision makers shall be minimized significantly (Government of Western Australia, 2016). However, findings in the Waterlow case raises crucial areas that can necessitate restrictions. In the event that the decision maker foresees the risk of harm to himself or others, restrictions can be upheld and that common sense is expected to prevail in predicting the risk of harm (Ryan, Callaghan & Large, 2012). Other research also perceives the additional harm provision in the Australian law reform as a form of discrimination for persons lacking the decision-making capacity and further suggest that it could be replaced with the best interest test (Szmukler, Daw & Callard, 2014; Callaghan & Ryan, 2012). The third and the fourth principles of the Western Australian mental legislation seeks to enhance respect and recognition among the various values, needs, and circumstances of dementia patients while advocating for participation that encourages the involvement of patients (Government of Western Australia, 2016). Finally, these decisions should be seen to enhance efficiency, effectiveness and equity. In this case, resources shall be utilized in the most efficient manner possible (Glover-Thomas, 2013; Ryan, Callaghan & Large, 2012). The applicability of these principles may be derailed by the introduction of other legislation seeking to protect the interest of the dementia patients but at the same time discriminating against their treatment needs. Certain concerns have been raised regarding the contravention of the principle of efficiency, effectiveness, and equity, which requires legislation to apply parity between mental disability and other disabilities. For instance, the NSW Mental Health Act 2007 restricts treatment of psychiatric disorders using electroconvulsive therapy while at the same time prohibits the use of deep brain stimulation and psychosurgery. It is argued that these forms of treatment are essential for patients with neurological disorder while at the same time, the available clinical evidence on safety and efficacy does not justify imposing restrictions (Loo, Trollor, Alonzo, Rendina & Kavess, 2010; Szmukler, Daw & Callard, 2014). Such legislations are therefore seen, by this school of thought, to be discriminative to patients with mental disorder and do not work for the best interest of the mental patients. There is a need therefore to balance the aim to facilitate safeguards with the objective of enhancing psychiatric treatment (Loo, Trollor, Alonzo, Rendina & Kavess, 2010). Another benefit brought forward with the application of the mental health parity legislation such as the United States 2008 Mental Health Parity Act, is the requirement for insurance providers to provide same or comparable benefits for physical health and mental health care patients (US Department of Labor, 2010). This provides an avenue for legislation to facilitate improved services to dementia patients. The Proponents, on one hand, argue that such legislation shall be instrumental in enhancing the required treatment as we...