The department issued Seeking Consent; Working with People in Prison in 2002. It was issued to prisons by means of Prison Service Instruction (PSI) 38/2002, which should be read in conjunction with Department of Health guidance Reference Guide to Consent for Examination or Treatment issued in 2001. Both documents are available on the department's website and have been placed in the Library.
The issues covered in Seeking Consent; Working with People in Prison includes the right of a competent adult patient to refuse treatment; assessment of “competence”; circumstances in which patients who lack capacity can receive treatment; the position of young people; dealing with violent or threatening behaviour, where patients may also have associated health problems; self-harm and food refusal.
Guidelines on the clinical management of people refusing food in immigration and removal centres and prisons have been developed and will be published shortly by the department.
There is no specific guidance on this particular area in relation to secure mental health hospitals. In certain circumstances, treatment can be provided to patients detained under the Mental Health Act without their consent. Such treatment needs to be for their mental disorder, but in some cases that can include treatment for physical health problems where this is related to the mental disorder.