The decision process of the mental health review tribunal—2. Analysis of research findings
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In response to applications, the tribunal should have the power to order delayed discharge by a given date. Improved access to the tribunal should help to safeguard some patients in the future from the dilemmas resulting from unnecessarily prolonged periods of hospital care. Legislation and/or government policy should be changed to require responsible health authorities to provide health care in hospital to enable a resident leave maximum security. The legislation which defines local authority responsibilities to provide residential care should be strengthened to allow their residents to leave security hospital care and the necessary resources made available. A period of statutory after-care (6 months at least) should be a condition of discharge under section 26 or 60. There should be the statutory requirement for local authorities to provide supervision to patients discharged from detention under mental health legislation. Tribunal powers should be extended to include recommendations for transfer or conditional discharge, or trial leave during the period of delayed discharge or adjourned consideration in response to applications. The tribunal authority to require the attendance of witnesses should be strengthened. The position of the patient's respresentative as essential both to the patient and the operation of the tribunal should be acknowledged and strengthened. The tribunal should be required to record the reasons for their decisions, for the information of all parties concerned. The 'judicial' status of the tribunals should be strengthened to gain greater credibility and authority, particularly in respect of patients detained in special hospitals. There should be clear statutory recognition of the continued responsibility of the responsible health authorities while their residents are in special hospitals, this joint responsibility to be reflected in the working relations between the health authorities and special hospitals. Closer and more effective working relations between special hospitals and health and social services should be promoted by greater 'regionalization' of the special hospital service. Special hospitals should be sanctioned to provide facilities for short-term 'informal' rehabilitative care in cooperation with health and community services.