Comments on “Mental Healthcare Act, 2017, and addiction treatment: Potential pitfalls and trepidations”
Notice bibliographique
Résumé
Sir, In a first article of its kind, Rao et al.[1] deliberated on the advantages and limitations of Mental Healthcare Act (MHCA) 2017 with respect to addiction management. The authors correctly pointed out the mistake made by the drafters of MHCA in using the term “abuse” in the Act's definition of mental illness and also elaborated some of the positive aspects of the Act such as its emphasis on humane treatment. A hypothetical case scenario is presented in the article. A person drinks on alternate days, indulges in physical violence, has deranged liver function tests but drinks despite that, has not appointed any nominated representative (NR) or made an advanced directive, and is brought by the family to a mental health establishment for admission. The article opines that the person fulfills the International Classification of Diseases-10 criteria for one mental illness (harmful use of alcohol), his wife fears bodily harm from him, and he is showing an “inability to care for himself to a degree that places him at risk of harm (liver derangement) to himself.” Based on the above, and as “the wife becomes the NR in this scenario,” the authors conclude that “the various requirements of Section 89 of the MHCA, 2017, are met” and that hence, he can be admitted under the section. However, the authors did not take into account the requirement stipulated in Section 89(1)c, i.e., “the person is ineligible to receive care and treatment as an independent patient because the person is unable to make mental healthcare and treatment decisions independently and needs very high support from his nominated representative in making decisions.”[2] In other words, admission under Section 89 can be made only if the patient lacks sufficient ability or capacity to make independent decisions regarding mental healthcare and treatment. Although the proposed guidelines for capacity assessment are yet to be published, one can safely assume that a patient with harmful use of alcohol would have the necessary capacity to make relevant decisions (except maybe during periods of intoxication). The authors themselves subsequently say that “The capacity for taking decisions is preserved in most cases of SUD [Substance Use Disorders], even in those with dependence syndrome, except for periods of intoxication or during severe withdrawals.” Thus, it would not be possible to admit the described patient under Section 89. Hence, the authors' conclusion that “a literal interpretation of the MHCA, 2017, seems to indicate that involuntary admission is possible for most individuals suffering from SUD” is invalid. Also, their apprehension that “the Act, which was brought in force precisely for protecting the rights of people with mental illness, may be used to violate the rights of this individual” is unfounded. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».