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Welcome

Welcome to the eighth edition of the Scottish Executive's newsletter, 'Reforming Mental Health Law'.

In this newsletter, we tell you about the work the Scottish Executive is undertaking to implement the Act including an update on progress of Joint Local Implementation Plans, information on the various training programmes and information on the Improving Mental Health Information Programme.

In this Issue

Implementing the Act
Communications on the Act
Training on the Act
Tribunal
The Centre for Change and Innovation
National Programme for Mental Health and Well-Being
NHS Quality Improvement Scotland
National Review of Mental Health Nursing
Improving Mental Health Information Programme
Frequently Asked Questions
Keeping in Touch

News in Brief

• A National Review of Mental Health Nursing announced
• The National Programme for Improving Mental Health and Well-Being highlights local authority services designed to promote well-being and social development
• NHS Quality Improvement Scotland have issued a strategic framework paper for consultation, "Improving Mental Health Services in Scotland"
• Recruitment of panel members for the Tribunal is now complete and the President is in post
• Update on the work by the Centre for Change and Innovation who are looking at the management and treatment of people with personality disorders

Implementing the Act

Our work over the last few months has been very focused on finalising the regulations which complete the legislative framework and reviewing the Code of Practice, both to take account of the comments made from last year's consultation exercise.

We are planning to complete this work soon and an electronic version of the Code will be available. Printed copies will take a bit longer to produce.

Joint Local Implementation Plans

Deadlines for updated Joint Local Implementation Plans is 30 June and monthly thereafter as we move towards the key October implementation date. Included in the update process is the Implementation Indicator designed to show summary risk assessment for key activities. This information will now be a feature of all future JLIP updates. For further information, please visit www.show.scot.nhs.uk/mhwbsg/jlip

A programme of visits is taking place to allow an opportunity to further discuss progress locally with the overall implementation. Prior to each planned visit, an updated Implementation Indicator will be requested so that all concerned have the most up to date position on which to base discussions.

Communications on the Act

Topic guides

We are in the process of reprinting the guidance for making an advance statement and nominating a named person. These guides are still available on the Mental Health Law website and if you require a hardcopy please contact us with your details and we will issue copies as soon as they are reprinted. The short guide to the Act The New Mental Health Act: What's it all about? - A short Introduction has been translated and is now available electronically in eight community languages which are available via contacting the Mental Health Law Team. An easy read format is currently being produced. We are also planning to produce further information in easy read and community languages as well as appropriate formats for children and for people with sensory impairment.

The Communications Working Group is continuing work on producing further topic guides for service users and carers and the following topic guides will be published over the coming months:

• Consent to Treatment
• A guide for people involved in criminal justice proceedings
• Responsibilities of NHS Boards and Local Authorities
• The Role of the Mental Welfare Commission
• The Tribunal
• The Rights of Carers
• Your right to independent advocacy
• A guide to emergency and short-term powers

Information for GPs

Over the coming months we will be working with Scottish Executive and NHS Education Scotland colleagues to provide information on the new Act for GPs. The information will be contained on a CD- ROM and is likely to include:

• all the key learning points for GPs
• identification of the differences, for GPs, between the 1984 and 2003 Acts
• the resource materials that GPs would use
• video clip providing a brief overview of the 2003 Act

The launch date for the CD- ROM will be announced in the next newsletter.

Training on the Act

Mental Health Officers ( MHOs)

Almost all areas in Scotland proceeded with their MHO training as planned. Attendance has been good and people feel they have learnt a significant amount in preparation for the new Act.

Areas that split the five days' training around a weekend felt that helped and may be worth copying for future training courses.

In some areas, psychiatrists, GPs, community psychiatric nurses and occupational therapists attended some of the training and reported on the added value for all.

Approved Medical Practitioners

Dr Mark Taylor has been on secondment to the Scottish Executive part-time since last summer developing the training materials for psychiatrists for the 2003 Act. The training takes the form of a day of self directed web based learning (see www.nes.scot.nhs.uk/mha/amp) which ends with a self administered 12 question test which the psychiatrist must pass. Passing the test automatically notifies the RCP (Royal College of Psychiatrists) and a certificate is sent to the psychiatrist.

The second part of the training is a workshop based day which will be hosted by a NES trainer and a MHO trainer, and will be available at the four NES sites (in Aberdeen; Dundee; Edinburgh; and Glasgow) till October 2005. RCP has already been active in updating members and fellows on the training details.

Mark has also written a Guide to the Code of Practice which will be made available to all psychiatrists at their training day.

Tribunal members

Walkgrove Limited were awarded the contract to gather the training material and present training courses to our panel members. The pilot course was held in April and already declared a successful event by those attending. Eight more courses are planned between May and September, and will be held in various locations across Scotland.

NHS Education Scotland ( NES)

Since its launch in January 2005, the NES e-learning resource has been accessed by a wide range of professionals across Scotland. NES are in the process of disseminating the paper and CD version of the material. The resource is sited at www.nes.scot.nhs.uk/mha/elearning

If you would like information about NHS Education for Scotland's work, please contact:

Patricia Howie
NHS Education for Scotland ( NES)
Hanover Buildings
66 Rose Street
EDINBURGH EH2 2NN
Tel: 0131 220 8685
E-mail: patricia.howie@nes.scot.nhs.uk

Tribunal

Appointment of President

In February, Deputy Health Minister, Rhona Brankin announced the appointment of Mrs Eileen Davie as President of the Mental Health Tribunal for Scotland. Mrs Davie has been an Advocate since 1989 with a substantial civil practice, covering a wide range of subjects in both public and private law. Prior to her legal training, she was a Senior Psychiatric Social Worker. Mrs Davie is in post and will be based at Bothwell House, Hamilton.

Panel Recruitment

Recruitment for panel members is now complete. We now have 72 medical members and 138 general members, who join our 98 legal members.

The general members are represented by a broad spectrum of people who all have the skills and experience to sit as general members of the MHTS (Mental Health Tribunal for Scotland).

They include:

• 14 people who have experience of mental disorder, and of using mental health services
• 8 people who are carers for service users
• 47 people who are registered nurses with mental health experience
• 6 people who are clinical psychologists on the British Psychological Society's register
• 50 people who are social workers with mental health experience
• 4 people who are occupational therapists with mental health experience
• 4 people who are employed in the provision of a care service
• 4 people who are employed in the management of the provision of a care service

Centre for Change and Innovation

The Centre for Change and Innovation ( CCI) has been commissioned by the Mental Health Division to look at the management and treatment of people with personality disorders ( PD) in Scotland. This work commenced in November 2004 with a stakeholder event to which 35 people were invited. The product of this two day meeting was a report entitled "Demanding Patients or Deserving People? Delivering Improved Care: A Discussion Paper". The general view of those people who attended the event was that 'the management of people with PD in Scotland has many of the characteristics of a failing service. It is not clear who is responsible and there is a lack of understanding of and empathy for people with this condition'. This paper was circulated to over two hundred named individuals across the health service, the voluntary sector, professional organisations and local authorities. Over fifty responses were received to the consultation. These responses have been reviewed and a summary document has been produced. The main issues raised from the consultation were that:

• improvements need to be made in the services for this neglected group of patients
• a network needs to be established to support the staff working in this field
• standards and guidelines would be very useful, and
• a recognition that borderline PD offers the best hope for treatment and should be the initial priority.

The next stage of this work will be a much larger stakeholder conference on 22 September in Glasgow. One hundred people have already registered to attend this conference. The focus for this event is about how we now start to move the agenda forward and make change happen. There is both a need to bring about better care and treatment for this patient group but at the same time we need to take stock of the many other pieces of work that are currently underway, such as the implementation of the new Act in October.

Although there may be pressure from some quarters to make change happen we need to be more aware of what the key changes are that need to take place and what the most realistic and sensible way is for taking these forward. The work is getting lots of attention and indeed the content of both papers has been very topical amongst consultant psychiatrists across Scotland. It is now on the agenda for the Royal College of Psychiatrists, Scottish Divisions' annual conference taking place on 2 and 3 June. The event will take the form of a debate. However, we need to make sure that all professional groups involved in caring for this patient group are involved in the way that future services are shaped. The September conference will give focus for this and allow all interested parties to discuss what the best approach to this might well be.

If anyone would be interested in attending the conference or receiving copies of either of the two reports, please contact Alex McMahon directly on 0131 244 2816 or alex.mcmahon@scotland.gsi.gov.uk

National Programme for Improving Mental Health and Well-Being

The Mental Health (Care and Treatment) (Scotland) Act 2003 places a duty on local authorities to provide or commission services designed to promote the wellbeing and social development of people who have, or have had, mental disorder. These should include social, cultural and recreational activities, training and assistance in obtaining and undertaking employment.

This is a challenging agenda, not least because once people with mental disorder enter mainstream activities, training and/or employment they rightly become "invisible". However, it can make it difficult for mainstream activity providers (clubs, evening classes, gyms, drama groups) to know if they are meeting need.

The National Programme for Improving Mental Health and Well-Being has commissioned Peter Bates from the National Development Team in England to deliver four regional residential seminars to address this complex agenda. Peter was previously seconded to the National Institute for Mental Health in England and the Social Inclusion Unit and has co-written the Day Service Modernisation toolkit for the Valuing People Support Team.

Every local authority and the lead health people from Community Health Partnerships and secondary mental health services have agreed to attend these important sessions. It is hoped that by gaining more skills and toolkits, these leaders will be able to return to their areas and progress the social inclusion agenda.

NHS Quality Improvement Scotland

In line with the Scottish Executive Health Department's national priorities, mental health is one of the core themes of the NHS Quality Improvement Scotland ( NHSQIS) work programme. NHSQIS has now developed a draft strategic framework: Improving Mental Health Services in Scotland. The proposed strategy gives a context within which a coherent approach to the work of NHSQIS can be developed, with the aim of delivering better outcomes for all those using mental health services.

The strategic framework is being issued for consultation to get as much feedback from stakeholders as possible; the consultation process will remain open until 27 June 2005. You can find the document and the consultation response (which can be completed online) at: http://80.75.66.189/nhsqis/qis_display_findings.jsp?pContentID=2315&p_applic=CCC&p_service=Content.show&

National Review of Mental Health Nursing

Chief Nursing Officer for Scotland, Paul Martin, has announced that a national review of mental health nursing commenced in March 2005.

The review is set in a progressive era of reform and development of mental health care and services in Scotland. The Scottish Executive has introduced a number of policies and initiatives aimed at improving mental health services, tackling health inequalities and improving the quality of life, well being and social inclusion of people who experience mental health problems. The full implementation of the Mental Health (Care and Treatment) (Scotland) Act 2003, heralds a new era of rights based mental health care in Scotland.

Mental health nurses are the largest professional workforce group in mental health care and make a significant contribution to the work of NHSScotland. The review will consider how mental health nursing can best be developed in a way that enables the profession to support and influence the implementation of health policy and drive the enhancement of mental health services both now, and in the future. The review will provide an opportunity to establish a strategic framework that provides a clear vision for future directions for the professions. It aims to enhance the role of mental health nurses to ensure the best evidence and values-based practice can be delivered in order to improve the outcomes and experience of care for service users.

The review will be conducted in a way that enables the full involvement and ownership of key stakeholders and reflects the Scottish Executive's commitment to place front-line health care workers in a position to drive service development and improvement. A number of structures and activities will determine the focus and outcomes of the review and support the review process, including;

• A National Review Steering Group;
• Expert reference groups representing mental health nurses and service users and carers;
• A range of consultation activities including conferences, focus groups, open forums, direct meetings with key stakeholders and consultation documents inviting views about key issues arising from the review; and
• A review of published literature.

The review will report in April 2006.

Susanne Forrest has been seconded to the Nursing Directorate of the Scottish Executive as Project Officer. The secondment is for a period of one year until the end of March 2006. Susanne is Senior Lecturer in Mental Health Nursing at Napier University. Further information on the review is available at www.show.scot.nhs.uk/sehd/nrmhns

Improving Mental Health Information Programme

ISD's Improving Mental Health Information Programme ( iMHIP), in collaboration with the iMHIP reference group and the Scottish Executive Health Department's Mental Health Division, have just released a draft Mental Health Information Strategy for Scotland for consultation. The consultation documents can be accessed on iMHIP's website at www.isdscotland.org/imhip and the consultation will run until the end of July.

The strategy covers five areas and suggests priorities in each. The five areas are integrated service user information; local and national management information; local service & access information; information for service users on conditions; and access to the evidence base. The focus is however on information to support integrated care, and for quality improvement and management of service (the first two areas).

Frequently Asked Questions

How is work on the forms progressing?

The Commission IT team with support from the Mental Health Law Team and the Tribunal team continue to work on the new forms for the Act, finalising the wording and converting to final format. The MWC are still looking into the feasibility of the person who creates a form being able to save it without having to buy additional software.

Staff at the Commission have been talking to Medical Records staff about what they would need in terms of training on the forms. They are currently considering the delivery of specialised training in September. They are also planning to develop a package of support material to accompany the forms, such as a table of all forms, purpose, when the forms should be completed, who completes which part, where to send once each part is completed, which ones have to be copied to MWC and whose responsibility this is.

Keeping in Touch

To comment on this newsletter or any aspect of implementing the new Act, to send us a new question for our question and answer section, or to offer an article for the next newsletter, please contact:

Mental Health Law Team

Scottish Executive Health Department
St Andrew's House, 3:E(N)
EDINBURGH
EH1 3DG
e-mail: mentalhealthlaw@scotland.gsi.gov.uk
website: www.scotland.gov.uk/health/mentalhealthlaw

To order paper copies of this newsletter, please contact us by e-mail at mentalhealthlaw@scotland.gsi.gov.uk or phone 0131 244 2591.