Mental Health Transfers (Sections 48 & 47 of the Mental Health Act 1983)AbstractMental health is one of the concerns in the establishment of the Mental Health Act in 1983.

  Included in the coverage of the said study is the determination of the possible causes of the delays in the Mental Health Transfers for prisoners that require mental healthcare attention that can only be given in a mental institution.  The Mental Health Act is the main point of view to be able to determine these causes.The results of the study were achieved through the application of the techniques of qualitative research study.  Through the research that was undertaken the possible reasons for the delay in the transfer of mental cases in prison that needs medical and institutional care was determined.The main focus of the study is the determination of the possible causes of the delay in the transfer of prisoners seeking for medical care in mental institutions.

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  The result of the study points out to the policies regarding the procedures to be undertaken to be able to ensure the health the patient and the legality of the action.  The security and the verification of the phases required is the main reason for the delay in the transfer. IntroductionMental health is one of the main concerns of the society.

  The prevalence of such cases renders the need for the legality of the matters that are related to the particular issue.  One of the issues being faced by the legal system are the policies regarding the mental health transfers of patients that are imprisoned.  The issue became a subject of interest due to the cases that require attention specifically from mental institution and medical care.The issues related to the establishment of policies that are related to the legal mental problem are included in the areas that experiences difficulties on the basis of different stages.  In the United Kingdom, even as one of the developed countries, development and policy implementation hindrances can also occur.  These problems are prevalent in the society which is happening regardless of the economic status and other aspects (Kemp, 1993).The main focus of the study that was conducted is to present the main possible reasons for the delay that are experienced during the transfer of patients that require medical attention from the prison to medical and mental institutions.

  The objectives were achieved through the analysis of the laws that were set and the procedures to be undertaken in the process of the transfer.  Also, the requirements pertaining to the said condition were also included in the main conditions and issues studied.The topic was viewed through the medical and the legal aspects of the issue.

  Concerns that are included in the study are the security of the process and the view of the medical institution on the needs of the people involved.  The said issue is tackled through the diverging views of the two institutions.  Included in the issues related to the subject matter are the delays that can be surmised on the basis of the interaction between the interacting factors, the law, the justice system, the medical institutions and the needs of the people involved.The course of the study conducted revolves around the interaction of the medical institution and the law.  This is when is comes to the treatment of the patient specifically dealing with the issues of allowing prisoners to be transferred to medical institutions in cases that the need arise.

  Although it is considered a fact that the people serving sentences in prison necessitates the attention of mental health professionals, there are special cases wherein patients require the environment that can only be given in medical mental institutions.  Literature ReviewDue to the prevalence of the issues regarding mental health in the society, the study that deals with these issues can be considered prevailing in the academic field.  The medical field considers the mental health as one of the most important field due to the fact that the prevalence of the said medical conditions can affect the society such as other conditions, but in such cases more attention is required due to cases wherein the cases can be shrouded and a comparatively deeper study is needed (Brooker and Repper, 1998; Singleton, Meltzer, Gatward, Coid and Deasy, 1998).

Mental health issues are included in the focus of the study conducted by the World Heath Organization.  In the study regarding the medical conditions specifically the ailments related to mental aspect is one of the main focus and became the basis of the establishment of the policies and laws.  One of the most significant results of the study conducted is the interdependence of the different sectors in the society.  This can be considered essential in the treatment of the patients with mental conditions.

  In this case the two sectors that are involved are the medical and the legal correction sector (World Health Organization, 2001).  The extensive coverage of the issues discussed by the organization can show the importance related to the study of the mental conditions in relation to the prisoners which are one of the main targets for the establishment of the policies.The importance of the attention that is given to cases of mental ailments is required due to the prevalent of the said cases.  Based on the study that became the main basis of the study conducted by Fryers, Brugha, Grounds and Melzer in 1998, mental condition such as psychosis can be considered to have a significant occurrence in Great Britain.  Functional psychosis is observed in 7 of 100 sentenced men.  In 1out of 10 men on remand psychosis is also observed.  With regards to women prisoners, psychosis is present in 14% of the two cases (Fryers, Brugha, Grounds and Melzer, 1998).

In the study by Brooke, Taylor, Gunn and Maden, the main focus is the prevalence of the different types of ailments (1996).  Results are:Type of Disorder                  No. of Patients          Percent PrevalencePsychiatric disorder               469                             63%Substance misuse                   285                             38%Neurotic illness                      192                             26%Personality disorder               84                               11%Psychosis                               36                               5%Other/Uncertain                     36                               0.5%Source: (Brooke, Taylor, Gunn and Maden, 1996)Another result on the basis of the study is the determination of the patients in prison that require intervention that can be found only in medical institutions.  These cases comprise 9 percent of the population of prisoners requiring treatment outside the prison (Brooke, Taylor, Gunn and Maden, 1996).In 1983, the realization of the need to give attention to in particular to the mental patients diagnosed inside the prison became evident.

  Punishment was viewed to be impartial if a mental condition can be diagnosed in prisoners.  Conditions in prison are considered to worsen the conditions of the prisoners.  Based on the study that was conducted, attention is given to the conditions and diseases that are communicable and most commonly affect the prisoners.  In relation to this, the mental conditions and cases related in the mental capacity and behaviour of the patients are commonly disregarded.  Compared to the early conditions and policies though, the present law cover the attention that should be given to the patients that have mental ailments and impairments (Arboleda-Florez, 1983; International Center of Prison Studies, 2004).

Such realization of the special needs of the prisoners with mental conditions paved the way for the consideration of the transfer of the prisoner with mental conditions to a mental institution that can give medical care appropriate for the needs of the patient.  It must be taken into consideration that one of the needs of a mental impairment is the isolation (Arboleda-Florez, 1983).  This cannot be achieved due to the fact that prison can be considered as a dangerous surrounding specifically to these patients that are vulnerable to negative stimuli (International Center of Prison Studies, 2004).One of the most important studies related to the subject of interest is conducted to be able to determine possible techniques required to establish policies to be able to achieve the treatment required by the prisoners with mental conditions.  This takes into consideration the delays that occur in relation to the transfer of the possible patients.  The study focused to the achievement of policies compared to the objectives of the research that was conducted that focuses on the causes of these delays.  Also important in the study is the research method that is applied.  Qualitative research through the review of related references and the information gathered from the authorities and experts of the field regarding the issue.

  The result of the study achieved a policy where-in the delays experienced can be decreased.  Also, the policy set was based on the coverage of the treatment that is provided.  An improvement of the available services which is limited to emergency cases will be developed into inpatient attention, thus the need of these patients can be met in an improved way (Earthrowl, O’Grady and Birmingham, 2003).

The presented studies and results are some of the bases for the study conducted on the causes of the delay in the transfer and the treatment procedure in patients that are imprisoned to be given mental and medical care in healthcare institutions.  The results of the prior research are important in the follow through required in the particular field.  The contribution of the said studies is not limited in the data gathered but also in the techniques that are applied for the achievement of such results.The basic foundation of the study conducted to determine the causes of the delays in the transfer of mental patients that are imprisons from the correctional institution to the medical institution includes certain factors.  One of the factors considered is the prevalence of mental cases in prison.

  Another is the lack of attention given as well as the policies that result to delay in the treatment that is given.  These are the main points wherein the study conducted is founded.;MethodologyTo be able to achieve the objectives of the research that was conducted, the application of the qualitative research process was conducted.

  The objective in this type of research is mainly to present the overview of the topic of interest.  It also presents the possible factors that can affect the subject that is described.  The study was undertaken through the integration of the concepts gathered through the work of different research conducted related to the study.The research was conducted through the synergy of the data related to the possible causes of the delay in the transfer of the diagnosed patients that are imprisoned from the correction institutions to the mental institutions wherein the needed attention for the need of these people can be given.  The method that was utilized to be able to achieve the goals of the research is a descriptive form of qualitative research.  This was undertaken through data gathering on the printed and published works on the topic.  Description, data gathering of pertinent information and analysis are included in the process undertaken.

  The analysis of the data gathered that are essential to the topic is done mainly through the process of induction (Hoepfl, 1997).The course of the study was initiated through the determination of the main focus of the study.  This is considered to be the primary requirement in the study which consists of the need for the determination of the root causes of the delay in the transfer of the prisoners from the prison.

  The building of the data related to the issue is the subsequent phase undertaken.  This includes the determination and definition of the law that covers the procedure for transfer to the medical mental institution of the prisoners that needed care (Maykut and Morehouse, 1994).Prior to the study of an issue, the establishment of a philosophic perspective is an important step to be taken.  This is the main angle wherein the subject can be tackled with the highest effectiveness to be able to arrive at the goal set beforehand (Hoepfl, 1997; Maykut and Morehouse, 1994).  In the study, the point of view that is used is through the context of the Mental Health Act of 1983.  Although the main basis can be considered legal, an important view involving the medial aspect is also essential in the study.Upon the establishment of the course of action and the coverage of the research to be undertaken, the actual data gathering is the subsequent stage.  Conducting the actual research requires the need for extensive research covering a wide variety of references.

  When the related references are gathered, the extraction of essential concepts and ideas is undertaken.  The said action is possible through the planning of the consecutive actions that are needed to be undertaken.  After the collection of the required data, the categorization and the analysis of the data gathered were then undertaken (Maykut and Morehouse, 1994).The analysis of the data involves a comparative study as compared to the standards set of the particular field.  Through the said phase, validation of the gathered data was rendered unnoticed through the course of the study (Maykut and Morehouse, 1994).  Through the course of the study, it is also important to be conscious of the hindrances that are incorporated with the use of the qualitative method.  These obstacles can cost the integrity of the research that was conducted if neglected and failed to be dealt with.

  Included in such issues is the ethical consideration of the study (Myburgh and Poggenpoel, 2005).  In a qualitative research, the recognition author and forerunners of the ideas presented is essential.  This also ascertains the integrity and the credibility of the issue (Hoepfl, 1997).

  Based on the established course of the study undertaken, the data that was gathered was organized, presented and analyzed.;;;Results and Data AnalysisWith regards to the objectives set in the study conducted, there are two major fields that are taken into consideration.  These factors include the medical aspect of the issue and the legal factors.  When it comes to the study of the factors that can be pointed out as the main causes of the delay in the provision of mental care of the prisoners the subjects that can be included in the study are the policies and the dynamics that are set to be able to achieve the objectives.

There are different issues that are considered important in the society with regards to mental health issue.  In the study of the contemporary mental health, the policies are incorporated with the different institutions.  The main scenario that is taken into consideration is the cases of mental condition in patients that are imprisoned.

  The said issue was determined and analyzed on the basis of the Mental Health Act of 1983 on the basis of the transfer of prisoners with mental ailments and impairments from the prison to the mental institutions.;The Content of the Mental Health Act of 1983The transfer of the prisoners diagnosed with mental condition from the correction institution to medical institution is covered by the Mental Health Act of 1983.  The sections 47 and 48 specifically discuss the procedure to be undertaken and the requirement for such action.  The Mental Health Act is involved in the legal processes related to the cases.  These processes include the screening, the attention and the treatment and intervention given to the patients.  Thus, the said legal disclosure involves the total processes that incorporate the requirement for the transfer of patients to mental institution (Turner, 2004).A.

  Section 47 of the Mental Health ActThe section 47 covers the sentenced prisoner that falls under the conditions of the mental impairment.  Based on the said Act, the Home Secretary is the main authority that covers a warrant to be served by the patient to be able to be transferred in a medical institution for mental care (Prison Health, 2005).A permit for transfer can be possible through the compliance of certain conditions.  The conditions that are the basis for the issuance of the transfer to a certain prisoner are expressed in two rules.  One of the requirements is the condition of the prisoner must be any of the mental ailments such as mental illness, psychopathic disorder, acute level of mental impairment and related mental conditions that require special medical care and attention which cannot be given by other institution.  Also another essential consideration is for cases of mental health that continuously causes the relapse and worsening of condition.  In such cases, the medical care to improve or even stop the aggravation of health condition medical care is required.

  Another condition is involved with the recommendation that must be given by a medical practitioner of the specified area of expertise and that has exemplary performance in the said field for the advise to be approved by the Home Secretary (Prison Health, 2005; Turner, 2004).Upon the submission of the required documents, the processing of the request takes place with the patient admitted in a specialized healthcare centre.  The admission of the patients in a different institution during the process of decision-making and evaluation of the conditions fro transfer is one of the factors that result to delays (Turner, 2004).

B. Section 48 of the Mental Health ActSection 48 of the MHA is one of the two acts that express the requirements of the legal institution for the transfer of patients from prison to the medical institution.  The said section differs from the previous section on the basis of the coverage.  The prisoners that are not sentenced are covered in the particular section which can be characterised on the basis of the custody set by the court, civil prisoners and the persons that are reprimanded on the basis of the Immigration Act of 1971.  Based on the definition these groups, they are composed of the people that has committed certain faults in the society but considered excluded from those that committed serious crimes (Prison Health, 2005; Turner, 2004).

Aside from the rules set on the determination of the prisoners that are covered by the section, other requirements are similar to that in section 47 of the Mental Health Act.;The Procedure for Transfer Under the Mental Health ActThe determination of the procedure that is undertaken through the implementation of the MHA presents the data wherein the causes of delay can be based.  This will enable the attainment of the objectives of the study conducted.The initial requirement in the transfer of the prisoners with mental condition is based on the reports that are submitted which are the study and diagnosis of the medical practitioners regarding the cases of the prisoners.  Also the communication of the different groups within the legal and the medical divisions is the essential phase in relation to the delay that can be encountered in the implementation of the decisions on transfer of the prisoners that require medical care from mental institutions.  The Responsible Medical Officer (RMO) or the Clinical Director from the MSU, the institution that provides medical care is included in the important personalities that are involved in the process of implementation of the transfer.One of the important notions to consider in the transfer of prisoners from the correctional institution to the mental institution is the determination of the party that can initiate such transfer.  The process can be undertaken by either of the GP representatives from the prison which is the legal group, or the initiation of the doctors responsible for the diagnosis of the mental health patient (Prison Health, 2005; Turner, 2004).

Other important personnel in the undertaking of the transfer provide support to the group from the prison in the transfer of the prisoners.  The PCTs which are also referred to as the Primary Care Trusts work on the basis of the assignment of the Commissioner of the legal group.  It is important to consider that the PCT are considered to be the group that can hold the highest trust possible in the established system.  This is due to the fact that they perform the essential role in the transfer.

  Some of the personnel included in the said group hold the data vital for the patient (Prison Health, 2005).  It should be noted that the PCT groups depends on the set up chosen by the commissioner of the correctional institution included in the local commissioning system.  The PCT covers the functions such as the set security of the system, the Trust activities, the crime solution and forensic services and other related functions including the health unit.  The last function covers the function related to Mental Health (Prison Health, 2005; Turner, 2004).;Prisoners and the Right to Mental Care ServicesBased on the UN Basic Principles for Treatment of Prisoners, equal right to the most efficient and standard medical care is achievable by every member of the society including the prisoners (International Center of Prison Studies, 2004; Kemp, 1993).  In this regard, it is important to consider that delays that can occur in the provision of such services violate the rights of the prisoners to impartial access to healthcare privileges.

These are different ways to be able to exercise the impartial right to access of healthcare facilities and services.  One way of guaranteeing the availability of the healthcare for prisoners is the presence of medical facilities in prison as well as access to a medical institution in cases wherein the medical case encountered exceeds the capacity of the health service unit.  Due to the prevalence of the different health conditions occurring in prison, one of the moves that are being participated in by the different countries not only in the European region but also in other parts of the world is the incorporation of the agencies and institutions that provide health services.  The establishment of the institutions adjacent to each other can serve as an assurance of the provision of health services for the prisoners (International Center of Prison Studies, 2004; Prison Health, 2005).

In relation to the provision of the needs of the prisoners with regards to their mental health, it is important to consider the insistence in the speed of the process undertaken.  This is in relation to the right of the prisoner not only to access of the medical care required but also to the most efficient manner possible (Prison Health, 2005).  Thus, delay in the transfer can be considered as an inefficiency that can have detrimental effects to the health of the patients.;Causes of Delays in the TransferBased on the determination of the requirement and the procedure undertaken in the study, there are certain notions that can be considered as contributing factors to the delay in the transfer of the prisoners.  Basically, one of the main considerations is the movement of the prisoner through the process.  This is in relation to the procedure undertaken in the processing of the treatment of the patients from the mental institutions (International Center of Prison Studies, 2004; Prison Health, 2005).

There are different factors specifically observed in relation to the study.  One of these factors is the complexity of the procedure required to be undertaken in the process of transfer.  This is due to the fact that legal processes require different forms of counter-checking.  Thus, upon the diagnosis of the patient, based on the Mental Health Act, there is a complicated web of processes prior to the attainment of the intervention and treatment required.  Other possible causes of delay revolve around the complexity of the procedure undertaken as well as the requirements set by the law to be able to secure the application of the said legal system.

The importance of the attention given to mental cases can be considered as one of the most essential prevention to the occurrence of medical conditions in prison.  This is essential due to the prevalence of the mental conditions such as psychosis in correctional institutions.  It is important to consider the fact that it is the right of the prisoners to have access to medical care.The determination of the causes of the delay in the transfer of patients from the prison to medical institution is only a portion of the issue regarding medical care that the prisoners deserve.  It is an important consideration that the delays for transfer are decrease, because the right to efficient medical care can be translated to the duration and the time consumed and spent in the rendering to the services.

;ConclusionThe result of the study points out to the policies regarding the procedures to be undertaken to be able to ensure the health the patient and the legality of the action.  The security and the verification of the phases required is the main reason for the delay in the transfer of patients from the prison to medical institutions.Thus, on the basis of the rendered results of the study undertaken, the simplification of the processes undertaken for transfer is one of the needs that can be met.  This can be undertaken through the establishment of an easier system wherein lesser phases are undertaken to be able to process the transfer at a shorter period of time and decrease the delay.;ReferencesArboleda-Florez., J. (1983) The Ethics of Psychiatry in Prison Society.  Canadian Journal of Criminology, 25 (1), p.

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