Proposed Changes To The Mental Health Act

February 12, 2018 | 3 Comments

The Health Ministry has released the Mental Health Act Review Consultation Paper detailing proposed amendments to the Mental Health Act, and feedback on the proposals should be provided by February 28th.

Speaking at a press conference this afternoon [Feb 12], Minister of Health Kim Wilson said, “The Ministry of Health proposes a phased approach to amending the Mental Health Act.

“Phase 1 will address immediate issues that require urgent attention and Phase 2 will look at the longer term wholesale re-write of the Act which is some 50 years old.

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“The goal of each phase is to bring Bermuda’s mental health legislation in line with contemporary methods of care while balancing the need to protect the rights of the individual patients and the need to ensure public safety.

The Minister said the issues identified for the Phase 1 review which are the subject of this consultation are: Clarify the role of the nearest relative, establish Community Treatment Orders, ensure consent to treatment is obtained, and establish requirements to determine mental capacity.

Minister of Health Kim Wilson’s remarks:

Good afternoon,

As Minister of Health, I am especially pleased to announce my Ministry’s consultation on proposed amendments to the Mental Health Act.

I have spoken on various occasions about this upcoming work, and it gives me great pleasure to share with the public the Mental Health Act Review Consultation Paper developed by a committed and expertly-qualified Steering Committee and Project Team.

These teams have been working on the proposed amendments for the past year, and the Consultation Paper and supporting documents provide an excellent overview of the proposals. I highlight that this excellent work was commenced under the previous administration, and I am committed to advancing good work that aligns with this Government’s priorities. Indeed, raising the awareness of mental health and the issues surrounding those persons within our community affected by mental health challenges is something about which I’m personally passionate about.

In brief, due to the urgency of some changes needed, and the magnitude of the full reforms envisioned, the Ministry of Health proposes a phased approach to amending the Mental Health Act. Phase 1 will address immediate issues that require urgent attention and Phase 2 will look at the longer term wholesale re-write of the Act which is some 50 years old.

The goal of each phase is to bring Bermuda’s mental health legislation in line with contemporary methods of care while balancing the need to protect the rights of the individual patients and the need to ensure public safety.

Issues identified for the Phase 1 review which are the subject of this consultation, are as follows:

  • Clarify the role of the Nearest Relative
  • Establish Community Treatment Orders
  • Ensure Consent to Treatment is obtained
  • Establish requirements to determine Mental Capacity

These proposals were developed jointly by the Project Team and Steering Committee to address major gaps that exist in Bermuda’s Mental Health Act.

The Ministry and Steering Committee now welcome the views of stakeholders and the public to ensure no concerns have been overlooked in the solutions proposed.

In summary, the proposed Phase I, immediate amendments include policy and legislative changes to achieve these aims:

First: Clarify the role of the Nearest Relative for patient admission

We propose to achieve this by Developing a Code of Practice to provide guidance to mental health professionals on admission processes of patients to hospital. This Code will require the Mental Welfare Officer to sign the admission forms upon consultation with the Nearest Relative. This removes the practice of the Nearest Relative signing the admission form which can result in non-admission due to the nearest relative’s fear of damaging their relationship with their loved one. This proposal is the current practice in the UK.

Secondly: Establish Community Treatment Orders

We propose to introduce provisions under the Act for Supervised Community Treatment in the form of Community Treatment Orders [“CTO”]. CTOs enable mental health professionals to treat patients granted leave from the hospital for extended periods of time. This amendment will enable conditions to be set for patients to live in the community [such as continuation of medication] while also improving legal safeguards to protect the rights of the patient.

Third: Ensure Consent to Treatment is obtained

The Act currently does not provide legal safeguards for patients who either cannot consent or refuse to consent to treatment. We propose to establish safeguards under the Act for patients regarding Consent to Treatment. The recommended provisions for Consent to Treatment will apply to all detained patients whether in hospital for treatment or living in the community under the CTO provisions proposed.

And Fourth: Establish requirements to define and determine Mental Capacity

We propose to introduce provisions under the Act for determining Mental Capacity, which at present are not established in law. The rationale for this proposal is that a patient cannot consent to or refuse treatment unless they have the Mental Capacity to do so. The Mental Capacity provisions recommended will define a person who lacks capacity, outline a framework for assessing whether a person is unable to make a decision and therefore lacks capacity, and ensure decisions taken for those who lack capacity are done so in that person’s best interests.

Feedback on the proposals in the Consultation Paper should be provided as outlined in the Consultation Requirements section by 28th February 2018. Feedback is preferred via the online tool, but can also be emailed or mailed to the Ministry.

Upon completion of the consultation, the feedback will be incorporated to determine final recommendations for policy changes and legislative amendments.

The Mental Health Act Consultation Paper can be found at www.gov.bm/health-public-consultations. For any questions or clarifications, the public may email moh@gov.bm.

Thank you.

The Mental Health Act Review Consultation document follows below [PDF here]

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Comments (3)

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  1. Fet Off says:

    Still waiting for those ever elusive stats.

  2. Real Deal says:

    Mental Health needs to be studied. this feels too much like a wheel chair move. as Bermuda gets more and more like the rest of the world more and more Mental Health issue will arise. we should studies people with Mental Health issues in order to better help them and come up with a solution that dose not include or requires less drugs.

    if when cant fixed the people right away we should come up with some kind of mental exercise kids can do when young that will strengthen their mind against Mental illness.

  3. Real Deal says:

    4.3

    Consent to Treatment is very tricky i don’t think drugs should be forced on some on unless they have gone out of there way to try and cause harm to some.

    i said it that way because if someone bothered the sick individual and instigated them then drugs should not be forced.

    them we get in the area where mental ill individuals cause harm to themselves.

    what is the law on suicide in Bermuda?

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