As an associate hospital manager I sometimes have RCs stating the patient is suffering from a mental disorder when it is agreed they have been asymptomatic for at least 6 months before. The diagnosis is often paranoid schizophrenia. I usually accept the diagnosis but feel it is wrong to agree they are still suffering from the mental disorder when they are well. I guess the response is that they are only well because they are being effectively treated by an anti-psychotic. Am I worrying too much about the semantics. Advice welcome
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Hi Jonathan
It’s a question of nature and/or degree of mental disorder. If a patient has had several relapses of psychosis, which have been associated with severe risk behaviour, but has been asymptomatic in the last few months of this current admission then I think ‘suffering from’ would still be appropriate terminology. There is a discussion of the meaning of nature and degree in the Overview of the MHA on this website.
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Hi, the way it was explained to us during AMHP training was with a parallel to a physical health condition, you could still be ‘suffering’ from the condition even though it was well controlled. e.g if you had epilepsy that was well controlled through medication, you would still be considered to have it.
Essentially, the way we were taught was the answer you are anticipating getting.
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Nature OR degree.
It is of course possible that the mental disorder is of both nature and degree, as indicated by Popplewell in the case which examined this issue (R v MHRT for South Thames Region (1999) 47 BMLR 104) “Although the wording of this phrase is disjunctive, in very many cases the nature and degree of the patient’s mental disorder will be inevitably bound up so that it matters not whether the issue is dealt with under nature or degree”
Hi Jonathan,
Having been an associate hospital manager years ago. I use to challenge the diagnosis sometimes, and it never ceases to amaze me sometime the doctors would state that the patient is suffering from a psychosis (a collective term) and that is what the patient is being treated for even after a decade. Nothing specific for whatever reason.
The criteria applied as you know is s.23 of the MHA (1983) and has equal standing to that of s.72. If the criteria is met for discharge, so be it. If not then the patient remains under detention.
As someone mentioned below, it’s actually not a question of Semantics, it’s understanding the nature of disorders. There’s a difference between an acute psychotic episode, let’s say, which can last for a few weeks and resolve and never return, vs someone having Chronic Schizophrenia. The Epilepsy example is perfect for a chronic disorder. Just because they are not having seizures doesn’t mean they no longer have Epilepsy…
Maybe if we ever end up with a new or an amended MHA the phrase ‘suffering from’ can be changed. People with an ongoing and long-term condition are not always ‘suffering’.
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Language is critical! That’s a really helpful observation.