The nearest relative in the Mental Health Act 2007: still an illusionary and inconsistent safeguard?

Abstract

The role of nearest relative (NR) is intended as a safeguard in the Mental Health Act 1983 (as amended in 2007) to curb the excesses of professional discretion and protect patients from unwarranted compulsory hospitalisation. It is unique to the mental health compulsory detention process in England and Wales. There are, however, evident tensions in the role and a lack of clarity surrounding the precise functions of the NR. There is also some uncertainty and confusion among practitioners about the scope of the NR involvement, and government plans announced recently to review mental health legislation will include a focus on the role of family and carers in the care of detained patients. Despite long-standing concerns about the role, there is remarkably little published research available to date on its use and effectiveness, in so far as evaluating the extent to which it provides an adequate safeguard for patients, as intended by the legislation. This article will briefly explore the background to the role, highlight some of the difficulties and tensions within it and conclude with some observations about where further research and reform may be needed to provide greater protection and clarity for patients, relatives and health and social care practitioners.     

An exploratory study of women prisoners’ attitudes towards their self-harm and the use of medical skin camouflage

Self-harm is a growing problem in UK prisons with women self-harming more than men. Self-harm can leave permanent scarring. Research on scarring suggests that living with scars can lead to psychological difficulties; however, there is little research on the specific effects of self-harm scars. Medical skin camouflage (MSC) can be used to cover numerous skin conditions. The use of MSC for women in prison with self-harm scars has not been examined previously. A focus group involving 10 women prisoners aimed to (1) explore feelings about self-harm scars, (2) examine effects that scars have on life in prison and (3) examine thoughts on using MSC in prison. This group formed part of a larger project designed to test the feasibility and acceptability of MSC for women who self-harm in prison. A topic guide was created with two service user researchers with experience of self-harm in prison. The results have been divided into three themes: (1) feelings about self-harm scars, (2) covering self-harm scars and (3) attitudes towards MSC. Our findings indicate that women in prison tend to feel embarrassed and self-conscious about their scars, and the presence of scars affects their relationships within prison. The women were enthusiastic about MSC, suggesting that it has the potential to affect women’s well-being and ability to engage with others.     

Immunochemical and chromatographic determination of ABH antigens in compact bone tissue

The identification of ABH antigens from compact bone tissue is known from many sources. The purpose of this study was to make a contribution to the localization of blood-group-active substances in compact bone tissue. A variety of preparation and identification methods were successfully used and compared. Samples were extracted from compact bone tissue, separated by HPTLC, and examined using the absorption-elution and PAP techniques. Additionally, the PAP technique was carried out on cryostat sections. Serologically active blood-group substances were consistently demonstrated in the organic components of the haversian canals.     

Microbial contamination of ABO antigens in bone tissue

Fragments of human bones were stored in different media for two years and then expression of the ABO antigens was indicated. Simultaneously, microbiological investigations were performed. In almost all cases, different ABO substances were detected in putrefied and fresh bones taken from the same person. Blood group antigens found in putrefied bones were compared with serological activity of bacterium cultured from these tissues. Attempts were made to remove unspecific reactions. The authors assume that bacteria are responsible for nonspecific serological reactions, not only as a carrier of blood-group-like substances, but also as a source of enzymes responsible for changes in the structure of ABO antigens in putrefied bones.     

Correction to: Coronial Inquests,Indigenous Suicide and the Colonial Narrative

Critical Criminology -     

Rapid determination of scopolamine in evidence of recreational and predatory use

In recent years, scopolamine has become a drug of common use for recreational and predatory purposes and several ways of administration have been devised. A method for the rapid analysis of suspicious samples was developed, using a portable capillary electrophoresis with contactless conductivity detection. The method allows the separation of scopolamine from atropine which has a similar structure and is present along with scopolamine in some samples. The method was demonstrated to be useful for the fast analysis of several types of evidential items which have recently been reported to have been abused with fatal consequences or employed for criminal purposes. An infusion of Datura stramonium L., in which scopolamine and atropine naturally coexist, was analyzed for being frequently consumed for recreational purposes. A spiked moisturizing cream and six spiked alcoholic beverages were also analyzed. In spite of the complexity of the specimens, the sample pre-treatment methods developed were simple and fast.