Religion, Belief, Mental Health and Safeguarding A clinician’s perspective Dr Lian Chua Consultant General Adult Psychiatrist in the Community Bradford City Sector Community Mental Health Team Beyond Belief Conference 8th Sept 2011

Senario 1 Mr A, 21 years old has a learning disability. His parents have arranged a marriage and see this as his religious right. They want him to have a carer in the future and believe he might get better. He has been deemed to lack capacity. Senario 2 Ms B, 30 years old she is from as staunch Christian family who hope natural alternative therapy and Christian faith will improve her mental health. Ms B herself has struggled over the years with her faith. She has stopped her antipsychotic treatment. She is becoming increasingly unwell but wants to continue medication free, her family support this.

Senario 3 Mr C, 24 is being taken by his family to see a spiritual healer. This healer has taken £1000’s from the family and beat the patient as part of the ritual. The family intend to take him again. The patient tells you that he may have no choice in the matter. Senario 4 Ms D, 30 years old mother and sole carer to her 5 year old son. She believes that her ex husband has made black magic against her and claims her son’s stomach has been eaten by him. She sees and feels the presence of spirits. She is from Africa and a Muslim. She is playing prayers on CD to protect her and her son and wearing protective amulets. She does not believe she is mentally unwell and would like to be left alone.

Responsibilities and a Duty to Act Criminal Justice Mental Heath Act 2007 Mental Capacity Act 2005 Adult safeguarding “ When a patient is lacking capacity through mental impairment, illness or disability and is believed to be being harmed, mistreated, exploited or neglected” Child safeguarding

A curious and fearless mind How do we make sense of the situation? Open, enquiring, caring – asking what you don’t know Holistic Decision making….. Do we have a duty to act? Is it in the best interest of the patient and least restrictive? How do we keep patient and family engaged? Is the plan safe? Is the plan right? This is a PROCESS, there may be several steps and more questions – seek them and the answers. These layers are part of the process and the solution. REFLECT … you are not alone …. these are opportunities to learn

THANK YOU