Two pieces of legislation aimed at bolstering Cayman’s mental health services have been gazetted.
The Mental Health (Amendment) Act 2022 clarifies how emergency detention orders are carried out, provides for orders for protective custody, and allows for restrictions to the use of postal services and electronic networks by patients.
The Mental Health Commission (Amendment) Act 2022 provides the Mental Health Commission the ability to hear appeals against restrictions imposed on access to mail and electronic networks by patients.
“The Ministry of Health and Wellness, the Mental Health Commission and multiple other partners have worked together to bring more clarity to numerous processes that directly impact some of our most vulnerable people: those with serious mental illness or who by reason of mental impairment may harm themselves or others,” Health Minister Sabrina Turner said in a press release about the gazettal of the acts.
She added, “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.”
Under the Mental Health (Amendment) Act, a new protective custody form is being created, which aims to streamline the process for the Royal Cayman Islands Police Service when acting on a protective custody order made by a medical officer – who is a registered psychiatrist or a clinical psychologist.
Protective custody orders are made when a medical officer needs the RCIPS’s assistance in bringing in a person suffering from a mental impairment or serious mental illness for examination by a government medical doctor.
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 the medical officer who can then contact the RCIPS with the location of the person in question.
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 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 a mental impairment or serious mental illness, a person is an immediate danger or likely to become a danger to themselves or others. Individuals taken by police constables into protective custody must be brought before a government medical doctor for an assessment no more than 12 hours from the time they are taken into custody.
Access to social media
The legislation is also being updated to reflect technological advancements, and includes a provision that allows medical officers to deny access to email or social media if they assess that such communication would have an adverse effect on a patient being detained under the law.
The previous iteration of the legislation dealt only with “postal packets”, which could be withheld from patients in detention if the medical officer decided receiving a letter or package could have an adverse effect on the patient.
Under the law, letters or parcels being sent by the patient could also be seized if it was felt that the correspondence would be “unreasonably offensive to the addressee, is defamatory to other persons,… or would be likely to prejudice the interests of the patient”. These provisions remain in place.
If the medical officer makes a decision to deny access to electronic networks, the patient or the patient’s nearest relative may appeal the decision directly with the Mental Health Commission.
Mental Health Commission (Amendment) Act
The Mental Health Commission (Amendment) Act 2022, the second legislation gazetted, provides the Mental Health Commission the ability to hear and determine appeals against restrictions imposed in respect to access to postal packets and electronic networks by patients.
The release noted that the regulations “will be submitted in due time to support the implementation of the amendments in legislation”.
The commencement date of the Mental Health (Amendment) Act is expected before the end of the year, after which the Mental Health Commission (Amendment) Act will also come into force.
Once both acts are enacted, the Mental Health Commission will notify both the Department of Psychiatry and Behavioural Health in the Health Services Authority and the RCIPS of the updated forms and the changes to the legislation.
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