Report on the Review of the Mental Health (Scotland) Act 1984

Executive Summary

INTRODUCTION

3. There has not been a fundamental review of mental health law in Scotland for more than 40 years. The law needs to be reformed to reflect the development of community based mental health services, the greater involvement of service users and carers in decisions concerning treatment, and the greater awareness of the need to respect human rights.

4. A new Act should be based on principles set out in the Act itself. The circumstances in which people with mental disorders should be made subject to compulsory care and treatment should be set out as precisely as possible.

5. A reformed system requires a new legal forum, which is able to address in a more considered way the particular issues which arise in mental health cases. A new mental health tribunal, which would replace the present role of the sheriff in mental health hearings, is proposed.

6. Although substantial reform is needed, it is important to retain the positive aspects of the 1984 Act. In particular, nearly 90% of patients receiving treatment for mental disorder in hospital are admitted on an informal basis, and the aim should be to preserve the emphasis on voluntary, rather than compulsory treatment.

7. However, there is a general need to strengthen and clarify the rights of service users, whether subject to compulsion or otherwise, to advocacy, information and services. The rights of carers also need to be strengthened.

8. It is also important to ensure that the rights afforded by the Act apply with equal force to people with particular needs, such as members of ethnic minority communities, children and people with disabilities.

9. The reforms proposed may, to some degree, increase the workload of professionals, who are already under considerable pressure. It will be important both that new procedures are as straightforward as possible, and that the need for greater support is borne in mind.

10. The extent to which the resources presently available to mental health services are adequate was not included in our terms of reference. We note, however, that the Accounts Commission has identified that no area in Scotland has a comprehensive range of services for adults with mental health problems, and the Mental Welfare Commission has highlighted continuing under-investment in maintaining in-patient services, alongside a dearth of therapeutic and recreational activities for many service users.

11. These findings are consistent with much of the evidence received by the Committee. Without adequate services, the aspirations which underlie the recommendations we make for new mental health law will not be fully met.

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