[leonora]

I am interested to know whether or not it is legal to be observed by a mental health worker i.e psychiatrist, without the patients knowledge. I was being admitted to hospital for an orthopaedic operation recently and I had an appointment with my respiritory consultant. A few days prior to this appt I had raised some concerns with my GP about the fact that I felt I was considered a troublemaker due to me being a litigation friend on behalf of a member of my family, and I was concerned it may adversley affect my treatment.

When I went into the appt with the respitory cons he introduced me to a colleague of his who was sitting in on the consultation, he did not give me his name, this colleague sat directly opposite me and watched me throughout the whole appt. It was not until later that day I had a niggling feeling I had seen this man before if I am correct I think he was the doctor who was taking notes at my psychiatric appt some years before.

This happened some months ago and I am still concerned about it I wondered if anyone can tell me if this kind of thing is done, I wonder if they were evaluating me before I went into hospital for surgery.

[ChrisB]

Hi Leonora,

I cant answer your question directly but I can say that I have met so many "observers" people in training, students from abroad etc and I havent worried about them too much, I certainly think its comon to have such people in consultations - they should ask if its ok with you though for them to be there and they should tell you why they are there.

[orderlydisorderly]

leonora, on 03 October 2011 - 10:57 AM, said:

I am interested to know whether or not it is legal to be observed by a mental health worker i.e psychiatrist, without the patients knowledge. I was being admitted to hospital for an orthopaedic operation recently and I had an appointment with my respiritory consultant. A few days prior to this appt I had raised some concerns with my GP about the fact that I felt I was considered a troublemaker due to me being a litigation friend on behalf of a member of my family, and I was concerned it may adversley affect my treatment.

When I went into the appt with the respitory cons he introduced me to a colleague of his who was sitting in on the consultation, he did not give me his name, this colleague sat directly opposite me and watched me throughout the whole appt. It was not until later that day I had a niggling feeling I had seen this man before if I am correct I think he was the doctor who was taking notes at my psychiatric appt some years before.

This happened some months ago and I am still concerned about it I wondered if anyone can tell me if this kind of thing is done, I wonder if they were evaluating me before I went into hospital for surgery.

If they really were carrying out a mental health assessment I think it would be lawful though bad practice. I don't think there's anything in the Mental Health Act or other legislation which says that you would have to be made directly aware of what was happening.

I've had this argument with others who've said it couldn't happen but the law is always open to interpretation, that's how it works. Like the stipulation that someone should be 'interviewed' by AMHPs and doctors before detention - what does interviewing mean in this context: shouting through a letterbox, merely saying 'you've been sectioned', do they have to give their names, designations or even tell you what they are doing? Actually I don't think they have to technically. When I was detained under the MHA, albeit many years ago, both times I wasn't told it was happening: one doctor was just looking at me and never spoke, and I had no idea what was happening and wasn't told - I guessed. The second time I guessed too and again, no mention of any assessment or who they were or why they were there.

They can always waffle their way out of it by saying it wasn't in your interests to let you know what was happening; it would upset you; make you angry etc.

[marykate4400]

They are not allowed to make any psychiatric assessment without informing the patient. You are not under section therefore you must give consent for any assessment to happen.

If the observer is a doctor, report to the General Medical Council if a nurse report to the Nursing and Midwifery Council. Either way if that is what happened - it was DAMNED wrong!

[CARL??]

Quite often doctors from another speciality do observe others, its part of their "professional development". It's one of those "2 way street" things, both of them get something out of it because they look at the patient in different ways.

I have been seen for a variety of ailments (I sound like a right "sicky") and a few times there has been another doctor there, but their presence has always been explained to me, and my consent asked for.

If it happens again you do have the right to ask who the other person is, and why they are there. You also have the right to ask to be seen alone by your specialist. They are obliged to carry out your request.

I wouldnt worry too much about the other doctors presence, it really could just be a co-incidence. Especially if you havent heard anything since.

You also have the right of disclosure, and are entitled to see your medical records. Although that can be wrapped in "red Tape" a bit by some hospitals, but you can get around it, by writing to the Chief Executive.

[leonora]

Thx everyone for your input, I am seeing the resp consultant again in November and I hope I will get up the courage to ask who the observer was last time, unfortunately I am so wrapped up in fear that all the medical profession consider me a trouble making nuisance of a hypochondriac, that I am always trying so hard to please, this in turn makes me angry and makes me feel they are hiding something from me, then again perhaps that is my paranoia and they are right and I am wrong. I always seem to be trying to justify myself.

Cheers folks.

[mabel]

leonora, on 04 October 2011 - 11:46 AM, said:

Thx everyone for your input, I am seeing the resp consultant again in November and I hope I will get up the courage to ask who the observer was last time, unfortunately I am so wrapped up in fear that all the medical profession consider me a trouble making nuisance of a hypochondriac, that I am always trying so hard to please, this in turn makes me angry and makes me feel they are hiding something from me, then again perhaps that is my paranoia and they are right and I am wrong. I always seem to be trying to justify myself.

Cheers folks.

Hi
Take a friend or family member in with you to your next appointment. First they can act as a witness to what goes on and even take notes. I know it's hard but find your inner stroppy - self ! You have the perfect right to know who people are in your consultation & why they are there. Good luck!
mabel x

[orderlydisorderly]

marykate4400:

'They are not allowed to make any psychiatric assessment without informing the patient. You are not under section therefore you must give consent for any assessment to happen.'

Can you point to the legislation that says an assessment is not allowed without 'informing the patient' please? I'd be interested in having that information as it is a vital piece of civil liberty protection.

At a recent speaking out against psychiatry event a woman spoke of a fairly recent detention under the Mental Health Act when 2 people she thought were police detectives (she'd just been the victim of a crime) turned out to be doctors, assessed and detained her without any warning or saying who they were or what they were doing.

[pezza]

Hi, The other doctor or observer has to state who he is and what is the reason for him being present in the room. a consent is needed from the patient and if the patient refuses to give consent then the doctor or observer should leave the room. Regardless off giving consent or not. your care/treatment should not be affected.

In terms of the mental health act. An ASW has to be present to carry out the assessment and the gp you see should also be present. it take's 3 people to section a patient long term. However there is a section where a patient can be detained for 72 hours for assessment to be carried out if their is not 2 doctors availible.

I wouldn't worry as other people has said it might have been his training etc

[orderlydisorderly]

I don't think leonora has anything to worry about and, as others have observed, he/she can always ask who the person is.

As regards the Mental Health Act, what is actually stipulated in writing isn't always what happens I'm afraid. Some professionals interpret the law very loosely and a person labelled mentally ill will have a lot of trouble getting anyone to believe them.

I'm actually in possession of a letter from the local Director of Social Services after I wrote to him complaining that I'd been investigated as being potentially dangerous without my knowledge by a mental health social worker. I didn't even live in the area where the investigation took place and only found out months later from a relative. The Director has written that the investigation was in accordance with 'good social work practice' and that they had a duty to make the people involved aware of our concerns. Apparently, as the person under investigation I was not one of the people involved. All my efforts in reading and interpreting the law would suggest to me that social services are within their rights to carry out an investigation behind someone's back. (This incident happened many years after my initial run-in with psychiatric authorities). They can probably justify it by saying something like it might have caused me to attack/threaten the people I was alleged to be a danger to if I'd been made aware of the investigation.

[marykate4400]

orderlydisorderly, on 05 October 2011 - 09:00 AM, said:

marykate4400:

'They are not allowed to make any psychiatric assessment without informing the patient. You are not under section therefore you must give consent for any assessment to happen.'

Can you point to the legislation that says an assessment is not allowed without 'informing the patient' please? I'd be interested in having that information as it is a vital piece of civil liberty protection.

At a recent speaking out against psychiatry event a woman spoke of a fairly recent detention under the Mental Health Act when 2 people she thought were police detectives (she'd just been the victim of a crime) turned out to be doctors, assessed and detained her without any warning or saying who they were or what they were doing.

All professionals involved are obliged to keep the patient fully informed - any assessment process should be person-centered and keeping the patient fully-involved in the assessment process. I just got rid of a very good book on mental health law and ethics, damned it can't remember its title or author but, just look in the Mental Health Act Code of Practice....

In the revised Mental Health Act 2007, it states amendments to the criteria for detention which, in short, states that it is not be possible for patients to be compulsorily detained, or their detention continued, unless appropriate medical treatment and all other circumstances of the case is made available to that patient which includes the whole assessment process. Look on Department of Health website. Hope that helps, its been a while since I did a module on this....sorry.

[orderlydisorderly]

marykate4400

I take your points about what's actually written but in reality things don't always happen that way and who is going to believe anyone who is subject to this?

In my 36 years with antipsychiatry and advocacy there have been many stories of procedure not being followed which can be justified due to 'emergency' etc.

'all other circumstances of the case is made available to that patient which includes the whole assessment process':

if a relative makes allegations against the person who may be detained this can be withheld on the basis that it may put that relative in danger or upset the person's mental health. In the same way, parts of medical notes can be withheld - further the patient does not have to be told that part of their record has been withheld.

You use the word 'patient', as professionals often do, but actually a person being assessed is not a patient as they have not yet been hospitalised so they are still not medicalised.

[CeeBee]

I thought that if the person being detained went to a tribunal they had a right to see all the evidence against them including full medical notes and any allegations so that they can prepare their case?

Although certainly at other times notes etc. can be legitimately witheld if it is considered they would cause a risk to the patient or to a third party.