Scottish Executive Environment Group: Draft Noise Management Guide: Guidance on the Creation and Maintenance of Effective Noise Management Policies and Practice for Local Authorities and their Officers in Scotland

APPENDIX 3.14 Dealing with Persons with Mental Disorder

1. SCOPE

1.1 There is no specific source of guidance on recognising and dealing with noise issues presented by mentally ill people. However, this appendix seeks to pull together several different sources of advice and good practice by local authorities to encourage appropriate liaison between the different agencies that may be involved.

1.2 To advise officers enforcing noise legislation on dealing with mentally ill people.

1.3 To ensure the special considerations associated with mentally ill people are met and understood.

2. INTRODUCTION

2.1 A proportion of people who cause or suffer from noise nuisance may have mental health problems. This section addresses the special considerations, including the legal considerations, which apply to people who cause noise nuisance and are diagnosed, labelled or treated as mentally ill.

2.2 The authority's Noise Enforcement Policy should contain specific policies and arrangements for dealing with people with mental disorder.

2.3 A balance has to be struck between the special needs of people who are mentally disordered and the need to protect the amenity and quality of life of their neighbours.

2.4 A noise nuisance case may be part of a wider social and health problem. Remedies other than abatement notices etc., including alternative legal remedies, may be available to secure a better and longer lasting solution. Consequently, a holistic approach is recommended.

2.5 This guidance note encourages Environmental Health Departments to develop partnerships and liaise closely with their own Social Services and Housing departments, and external agencies such as the Police, Health Services, Community Psychiatric Nurses and other organisations involved in the care and treatment of people who are mentally ill. Legal enforcement action should be used as a tool of last resort and new and innovative steps should be developed for dealing with mentally ill people who cause noise nuisance. An integrated approach is needed. People should not be prosecuted if they are known to be suffering from mental illness, unless all other remedies have been exhausted and that the offence is so serious that a prosecution would be in the public interest and would meet the tests set out in the Code of Practice for Crown Prosecutors (see Appendix 5.2 to this guide - on the Code for Crown Prosecutors).

2.6 Noise nuisance cases should be handled sensitively if the person responsible for causing the noise nuisance is known to be mentally ill. The person's mental state must be taken into consideration and advice sought from mental health professionals on how to deal with such persons.

2.7 Other agencies should be involved and consulted as far as possible to achieve a long lasting resolution of the noise nuisance. The agencies may include:

Social Services departments
GPs and other Local Health Services
the Community Psychiatric Nurse, and
other agencies involved in the care and treatment of mentally ill people, MIND and local mental health NGOs.

2.8 The relevant authorities should be notified if a person exhibits apparent serious mental disorder because the person may need treatment. However referral to other agencies should not be seen as the end of Environmental Health involvement with a case involving a mentally disordered person. The Environmental Health Department should liaise with other agencies to secure a lasting resolution, which strikes a balance between the needs of the mentally disordered person and the need to prevent others suffering statutory noise nuisance. The progress of the case should be monitored and liaison with other agencies involved should be regularly reviewed. If the partnership with other agencies is unable to secure resolution of the nuisance, noise enforcement action may have to be considered.

3. DEFINITION OF "MENTALLY DISORDERED"

3.1 From the Mental Health Act 1983 Part I, subsection 2:

"A 'mental disorder' means mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind and 'mentally disordered' shall be constructed accordingly;

A 'severe mental impairment' means a state of arrested or incomplete development of mind which includes severe impairment of intelligence and social functioning and is associated with abnormally aggressive or seriously irresponsible conduct on the part of the person concerned and 'severely mentally impaired' shall be constructed accordingly;

A 'mental impairment' means a state of arrested or incomplete development of mind (not amounting to severe mental impairment) which includes significant impairment of intelligence and social functioning and is associated with abnormally aggressive or serious irresponsible conduct on the part of the person concerned and 'mentally impaired' shall be constructed accordingly;

A 'psychopathic disorder' means a persistent disorder or disability of mind (whether or not including significant impairment of intelligence) which results in abnormally aggressive or seriously irresponsible conduct on the part of the person concerned."

3.2 From the White Paper: Reforming the Mental Health Act Part I, chapter 3, subsection 3:

"Consistent with the Law Society's recommendations, the Government proposes to use the following broad definition of mental disorder in forthcoming mental health legislation: any disability or disorder of mind or brain, whether permanent or temporary, which results in an impairment or disturbance of mental functioning."

3.3 Under the present Mental Health Act 1983, a person should not be dealt with as suffering from mental disorder by reason only of dependence on alcohol or drugs:

"Nothing in subsection 2 shall be constructed as implying that a person may be dealt with under this Act as suffering from mental disorder, or from any form of mental disorder described in this section, by reason only of promiscuity or other immoral contact, sexual deviancy or dependence on alcohol or drugs."

4. GROUPS OF PEOPLE LIKELY TO BE AFFECTED

4.1 People who have been discharged from long stay institutions.

4.2 People who have received in-patient care for acute episodes of mental ill health.

4.3 People who have an identified mental health difficulty but who receive treatment in the community.

4.4 People thought to be mentally ill but have not yet been formally assessed or diagnosed.

5. SUGGESTED PROCEDURE FOR DEALING WITH MENTALLY DISORDERED PERSONS WHO GENERATE NOISE NUISANCE

5.1 It is not usually until a statutory nuisance has been established and staff approach the person responsible that a person causing the nuisance can be identified as possibly being mentally disordered. The definition of 'mentally disordered' is explained above.

5.2 If a person responsible for a noise nuisance is identified as mentally ill, a Noise Abatement Notice may be served in accordance with usual Noise Enforcement Policies. However, special arrangements may be necessary to explain the requirements of the notice. A visit should be carried out and the person should be given advice about the steps that should be followed to comply with the notice. Where appropriate, the Environmental Health Department should liaise with Social Services and the Community Psychiatric Nurse before the notice is served, as their involvement may:

Result in the noise problem being resolved.
Enable the noise maker to more fully understand the consequences of their actions.
Result in seriously ill persons accessing effective treatment.

5.3 Liaison with Social Services and the Housing officer (if mentally disordered person is a Council or Registered Social Landlord Tenant) is important throughout the case. Upon initial suspicion of a person being mentally disordered, both these agencies need to be notified of your involvement with the person. Social Services may be able to provide assistance by explaining to the person the meaning of a notice or warning letter, and can clarify the nature of the mental disorder so that an action plan for resolving the problem can be tailored to the needs of both the noise maker and the noise victim.

5.4 If upon contacting Social Services the person who is considered to be mentally disordered is not known to them, a referral can be made for the person to be assessed by Social Services.

5.5 If EH staff become aware that there is a risk of the mentally disordered person causing harm to themselves or others, then the Emergency Duty Social Worker and/or and psychiatric crisis teams need(s) to be contacted immediately. In extreme cases of imminent risk of serious self-injury or injury to others the Police should be contacted straight away.

6. SEIZURE OF NOISE MAKING EQUIPMENT

6.1 Seizure of noise making equipment may be a short-term solution to contravention of the noise abatement notice. If seizure does become necessary, it is advisable to plan the seizure with the Police in advance as it is likely that the police will have to arrange for certain resources to be available. It is also advisable to inform Social Services and psychiatric services of the need for seizure and invite them to be present at the time of the seizure. The effect of the seizure on the mentally disordered person needs to be considered and the advice of mental health professional sought. The Housing Department or landlord will also need to be informed if the mentally disordered person is a Council or Registered Social Landlord Tenant. These agencies may be able to provide door keys if necessary.

6.2 Prosecutions should not be taken against anybody who is known to be suffering from mental illness at the time of the offence unless all other remedies have been exhausted and the offence is so serious that it meets the public interest test set out in the Code of Practice for Crown Prosecutors.

7. PROSECUTION

7.1 If the mentally disordered person is to be cautioned, a litigation friend must be present according to the Civil Procedure Rules. These rules contain special provisions that apply in proceedings involving patients as follows.

7.2 A Local Authority may not, without the permission of the Court

a) make an application against a patient before proceedings have started; or

b) take any step in proceedings except applying for the appointment of a litigation friend until the patient has a litigation friend.

7.3 A patient must have a litigation friend to conduct proceedings on his/her behalf.

7.4 If a noise offender becomes a patient during proceedings, no party may take any step in the proceedings without the permission of the Court until the patient has a litigation friend.

7.5 Any step taken before a patient has a litigation friend shall be of no effect unless the Court otherwise orders.

7.6 Where a defendant to litigation in the Civil Courts is a patient and there is no one suitable and willing to act as their litigation friend, the Official Solicitor will be prepared to act as litigation friend subject to his costs being covered.

8. CIRCUMSTANCES WHERE THE COMPLAINANT IS SUSPECTED OF HAVING A MENTAL HEALTH DISORDER

8.1 The evaluation of noise nuisance must be based upon objective tests, where the test is whether or not the offending noise could be considered a nuisance to the 'ordinary, reasonable man', i.e. the mythical figure on the Clapham Omnibus. Consequently, unfortunately in such an evaluation, any special sensitivities of the complainant due to mental illness or disorder cannot be catered for, nor can the unique sensitivities presented by tinnitus sufferers.

8.2 Under these circumstances, it would be appropriate to enlist the support of the specialist agencies, as described above, in an attempt to achieve a degree of amelioration for the

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