Laws revised to deal with custody of mentally ill

(CNS): Two pieces of legislation aimed at improving local mental health services have recently been gazetted. The Mental Health (Amendment) Act, 2022 clarifies the procedure relating to emergency detention orders, provides for orders for protective custody, and for restrictions to post and electronic networks by patients, among other things. The Mental Health Commission (Amendment) Act, 2022 allows the commission to hear and determine appeals against those restrictions by patients.

Health Minister Sabrina Turner said the ministry and multiple other partners had worked together to bring more clarity to the processes that impact vulnerable people with serious mental illness or impairment who may harm themselves or others.

“It is important to ensure that our legislation actively supports best practices, is relevant to the work that is being done by our healthcare professionals at the ground level, and as always meets the needs of patients while protecting their rights and dignity. I am happy to say that these changes will do just that,” she added.

The revision of the Mental Health Act calls for the creation and implementation of the protective custody form to streamline the process for the Royal Cayman Islands Police Service (RCIPS) when acting on an order made by a medical officer such as a psychiatrist or a clinical psychologist who has a doctoral qualification in that discipline registered under the Health Practice Act.

Protective custody orders are made when a medical officer needs police assistance in bringing a person suffering from a mental illness in for examination. Family members who are concerned for the health and welfare of a relative are also able to initiate the process by completing a “Request for Review” form which is submitted to a medical officer, who can then contact the police with the location of the potential patient.

The amendment also clarifies the procedure relating to emergency detention orders. The medical officer who made the order for protective custody may consult with the medical doctor employed by the government who examined the person, and if necessary, can make an emergency detention order for the person for up to 72 hours in a hospital or other place of safety where they are able to receive care.

Police constables will also be able to intervene more readily in situations where by reason of mental impairment or serious mental illness a person is an immediate danger or likely to become a danger to themselves or others. People taken into protective custody by police must be brought before a government medical doctor for an assessment no more than twelve hours from the time they are taken into custody.

The amendment also includes the use and access to electronic networks to allow medical officers to assess if they might have a direct or indirect adverse effect on the patient. If the medical officer makes a decision to deny access to such electronic networks, the patient or the patient’s nearest relative may appeal the decision directly with the Mental Health Commission as a result of the amendments to that legislation.

The Mental Health (Amendment) Regulations, 2022 will be submitted in due time to support the implementation of the amendments in legislation.

The commencement date of the Mental Health (Amendment) Act, 2022 is expected before the end of the year, after which the Mental Health Commission (Amendment) Act, 2022 will also come into force. Once both laws come into force, the Mental Health Commission will then notify the Department of Psychiatry and Behavioural Health and the RCIPS of the updated forms and the changes to the legislation.