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.     

A New Digital Method for the Objective Comparison of Frontal Sinuses for Identification*

Abstract: Use of the frontal sinuses for identification requires an objective method of comparison to meet Daubert standards. Christensen’s application of Elliptical Fourier Analysis and Likelihood Ratios seems to be a viable solution for this problem. The proposed method draws upon this work and attempts to simplify its application. Variation between pairs of digitized sinus tracings was quantified by summing the difference between corresponding measurements taken from a fixed origin to the outer edge of the sinus outlines using Adobe Photoshop^® CS2. Same‐skull and different‐skull pairs were used to develop reference distributions from which the probability of unknown pairs coming from the same or a different individual was estimated. Error rates of 0% were achieved. Resulting correlation coefficients demonstrated inter‐rater and test–retest reliability. Further refinement of the reference distributions and more rigorous testing of error rates should make this technique applicable to casework.     

The Impact of Procedural Information Costs on Voting: Evidence from a Natural Experiment in Chile

This paper uses a natural experiment to identify the effect of a procedural information cost on the electoral registration of young first-time voters. We exploit the fact that information about when the minimum age eligibility requirement is due, either at registration or election-day, is only meaningful for those turning 18 after registration closing day. Using a national dataset on Chilean registration over four elections, we provide evidence of a sharp discontinuity in the registration rate of those youngsters turning 18 at closing date. The effect is both sizable and robust, persists over time, and is similar across income groups.     

Elements Needed for Quality Batterer Intervention Programs: Perspectives of Professionals Who Deal with Intimate Partner Violence

Batterers intervention programs (BIPs) constitute a primary intervention for perpetrators of intimate partner violence (IPV). There is little understanding as to what elements are necessary for a good intervention program. We conducted 36 individual semi-structured interviews with professionals working with BIPs. Our results yielded three thematic categories: (1) optimal BIP structure—group size and program duration should foster change and interaction, (2) facilitator characteristics—co-facilitation is ideal, and facilitators should have IPV training, and (3) program approaches–programs should challenge their clients on their behavior, promote an environment of safety and openness, and strive to adapt to clients.     

Evaluation of a treatment program for battered wives

Research shows that of the abused wives who remained in a women's protective agency for a period of at least 2 weeks, 50% return to their abusive situation. Several theorists have advocated that battered women remain in their abusive situation because they lack skills necessary to extricate themselves. A program was developed to provide personal and vocational counseling for abused women. Over a 2-week period, abused women who volunteered for the experiment were given the opportunity to participate in group counseling which provided cognitive restructuring therapy, self-assertiveness and communication skills training, problem solving training, body awareness, and vocational counseling. Three groups participated in the experiment: a control group, a group with the COPSystem Interest Inventory and the Sixteen Personality Factors Questionnaire, and a group with the COPSystem Interest Inventory without the Sixteen Personality Factors Questionnaire. The group with the COPSystem Interest Inventory administration and interpretation showed significant improvement within group measures from pre- to post-treatment in anxiety, depression, hostility, assertiveness, and self-esteem. The group with the COPSystem Interest Inventory and the Sixteen Personality Factors Questionnaire utilization showed no significant improvement in any of the measures. It can be concluded that the women in the experimental group with the administration of the COPSystem Interest Inventory benefited from the therapy provided more than the women in the experimental group with both the COPSystem Interest Inventory and the Sixteen Personality Factors Questionnaire administration and interpretation. Limitations and directions for future research are discussed.     

Beyond the Cold War in Europe: A review article

Vilho Harle & Jyrki Iivonen, ed., Gorbachev and Europe. Pinter Publishers, London, 1990, xi+213 pp., £28.50.

Richard Davy, ed., European Detente: A Reappraisal. The Royal Institute of International Affairs, Sage Publications, London, 1992, viii+277 pp., £35.00.

Richard H. Ullman, Securing Europe. Adamantine Press, Twickenham, 1991, xv+183 pp., £13.50.     

Community elder-care in Tasmania: examining whether caregivers believe they "make-a-difference" in an urban and rural island

Adult caregivers (n = 184;Mage = 43.9 years old) working at a non-profit, eldercare program at five geographically diverse sites located in the self-contained, island state of Tasmania, Australia, completed a set of self-report measures. Results across the five sites indicated that respondents experienced a relatively strong sense of self-efficacy toward making a difference in their local community. However, there were significant differences (controlling for social desirability) when comparing caregivers from rural northern (n = 45) with urban southern (n = 139) communities, with rural caregivers claiming stronger sense of common mission with others, reciprocal responsibility to help others, and caregiver satisfaction, plus lower disharmony with other members and caregiver stress in helping the elderly than urban caregivers. Implications suggest that community self-efficacy may be high among eldercare staff, but their sense of community and caregiving perceptions may reflect geographic differences, especially in Tasmania.