Dr Anju Soni1, Dr Ian Treasaden
1Psychiatry Uk, London, United Kingdom
Biography:
Dr Anju Soni:
MB BS, MRCPsych with dual CCT in Forensic and General Adult Psychiatry (Rehabilitation endorsement). Extensive experience across secure forensic services, community settings, and prisons. Specialist expertise in neurodevelopmental disorders (ADHD/ASD) within forensic populations, including comprehensive assessment, diagnosis, and integrated treatment planning. Honorary Clinical Senior Lecturer at Imperial College London with broad teaching experience. Active researcher with publications in Lancet, Health Technology Assessment, and International Journal of Prisoner Health. Studies focus on neuroleptics, gabapentinoids, and personality disorders. Award-winning presentations at international conferences. Completed drug misuse management certification and training supervision modules.
Dr Ian Treasaden:
Currently Honorary Consultant Forensic Psychiatrist at West London NHS Trust, UK. He qualified in medicine from the London Hospital Medical College,University of London, where he was awarded the James Anderson Prize in Clinical Medicine, and trained in forensic psychiatry at the Maudsley & Bethlem Royal Hospitals in London and Broadmoor High Secure Hospital. He was appointed as a Consultant Forensic Psychiatrist at the Three Bridges Medium Secure Unit, West London NHS Trust in 1984, where he was also Clinical Director, and Honorary Senior Lecturer in Psychiatry at Imperial College London. He has also been a Mental Health Tribunal medical member in England. Author of papers in forensic and general psychiatry, he has co-authored the books Textbook of Psychiatry, now in its third edition; Mental Health Law: A Practical Guide, now in its second edition; Emergencies in Psychiatry; Psychiatry: An Evidence-based Text; and Forensic Psychiatry:Fundamentals and Clinical Practice.
Abstract:
Introduction: Mental health legislation, such as the Australian Capital Territory (ACT) Mental Health Act (MHA) 2015 and the England and Wales (E&W) MHA 1983 (as amended 2007), varies between legislatures with differing impacts on patient rights and involuntary treatment outcomes.
Aims: To describe and compare ACT and E&W MHAs and rates of involuntary hospitalisation and tribunal reviews to provide evidence for future reform.
Methods: A comparative legislative analysis of both Acts was undertaken and datasets from the Office for National Statistics (E&W) and ACT Health Services used to evaluate resulting involuntary admission rates, mean detention duration, and tribunal review frequency across both jurisdictions.
Results: ACT has a narrower definition of mental disorder, shorter renewable detention orders and broader tribunal powers, including in detention and medication authorisation.
Annual involuntary hospitalisation rates were comparable (E&W: 0.087%, ACT: 0.075%). E&W have longer average detention durations (30-45 days vs. 21-35 days). ACT had significantly more tribunal reviews per patient detained (p<0.0001).
Conclusions: The differing legislative frameworks between jurisdictions influence involuntary treatment patterns. ACT’s shorter detention durations may reflect both its MHA and lesser provision of forensic services than E&W. ACT’s integrated hospital-community treatment orders offer more flexible care delivery. Its tribunals may enhance patient safeguards via their broader powers and more frequent reviews.
Impact: Comparative analysis identifies each legislation can inform reform of the other and provide frameworks for its services, particularly around tribunal powers and treatment order flexibility.
However, service improvements require both legislative frameworks and adequate resourcing to effectively support patient care.