Jhetam, Naeem Ahmed.
Abstract:
The aim of this study was to document the safeguards
inherent in the Mental Health Act (MHA) of 1973, and to
examine the extent " to which these are observed in
practice.
The research was conducted at Lentegeur Hospital in
Mitchells Plain, Cape Town. The population consisted
of 726 certified patients who were admitted
involuntarily (i.e. under sections 9 and 12 of the MHA)
from 01 January 1990 to 31 December 1990.
Data for each of these patients was collected from the
admission register, clinical files, administrative
files, and the certified post book. In addition, the
official hospital statistics were examined.
Measurements obtained included demographic data, the
validity of the document contents, the validity of the
certification process, and an overall measure of the
validity of each of t he certifications taking into
account both document contents and observance of the
time strictures set out in the MHA.
Twenty nine patients (4,0%) were admitted by Urgency
(Section 12), and 697 (96,0%) on Reception Order
(Section 9). The study focused mainly on the Section 9
patients, because of the small sample size for Urgency
admissions. It was found that 609 (87,4%) of the 697
admissions were legally flawed in terms of document
contents criteria and the time limits in the
certification process.
Document content criteria were not fulfilled in: 3,0%
of the Applications for Reception Order; 32,1% of
Medical Certificates; 20,1% of Reception Orders; and
3,6% of Reports to the Attorney-General. In 40,0% of
certifications the Report to the Attorney-General
(G2/28) could not be traced.
Examination of temporal safeguards revealed that the
least satisfactory aspect was the delay in the
completion of the post-admission Report to the
Attorney-General. It was found that 32,3% of these
Reports were not submitted on time.
Reasons for the discrepancy ("gap") between legal
standards and actual practice are discussed.
Recommendations are made which could help minimise or
eradicate this "gap". These include suggestions for
changes in the document format, for the use of a
certification booklet, for stricter control of late and
inadequate documentation, and for inservice training of
all those involved in the certification process.
