HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS British Journal of Psychiatry Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Bennett, D. M. Articles by Mitchell, K. M. Search for Related Content PubMed Articles by Bennett, D. M. Articles by Mitchell, K. M.

Is the Mental Health (Care and Treatment) (Scotland) Act 2003 the least restrictive option?

Royal Cornhill Hospital, Aberdeen ABH 2ZH, email: danielm.bennett{at}nhs.net

Kenneth M. Mitchell, Consultant Psychiatrist

Royal Cornhill Hospital, Aberdeen

The Mental Health (Care and Treatment) (Scotland) Act 2003 became effective in October 2005 but the paucity of literature and debate surrounding it has been disappointing. The Act changed mental healthcare delivery in Scotland, and its positive aspects are described elsewhere (Darjee & Crighton, 2004; Thomson, 2005). The Act has defined principles (e.g. interventions should involve the minimum restriction of the patient), but paradoxically introduced a number of new restrictions on patients.

The ‘gateway order’ in the 2003 Act is a 28-day short term detention certificate. Proponents suggest that this 28-day detention order with compulsory treatment is less restrictive than a 72 h (emergency) detention period with no compulsory treatment, as the latter gives no right of appeal.

Previously, it was common psychiatric practice to grant ‘time off the ward’. Now formal suspension of detention is required before patients leave hospital grounds, even for short periods. The responsible medical officer may attach formal conditions to this.

The Act introduced the Mental Health Tribunal for Scotland which hears all applications for 6-month detentions. These formal and often adversarial hearings occur irrespective of patients’ objections and can be an ordeal for many patients.

Administrative demands on services have increased significantly, diverting clinical resources from the majority of (informal) patients, thereby limiting their service provision.

We therefore propose that the 2003 Act does not fulfil the principle of minimum restriction.

References

DARJEE, R. & CRIGHTON, J. (2004) New mental health legislation. BMJ, 329, 634 -635.[Free Full Text]

THOMSON, L. D. G. (2005) The Mental Health (Care and Treatment) (Scotland) Act 2003: civil legislation. Psychiatric Bulletin, 29, 381 -384.[Abstract/Free Full Text]

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Bennett, D. M. Articles by Mitchell, K. M. Search for Related Content PubMed Articles by Bennett, D. M. Articles by Mitchell, K. M.