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DirectionsReport on the Review of the Mental Health
(Scotland) Act 1984Laid before the Scottish Parliament
by the Scottish Ministers This document is also available
in pdf format (2.1Mb) CONTENTS
Membership of the Committee
Terms
of Reference
Summary of work
Acknowledgements
Introduction
to the Report
SECTION 1 FRAMEWORK OF A NEW MENTAL HEALTH ACT
Chapter 1 - The need for reform
Introduction
Changes in mental health care
Changes in legislation
Problems with the
1984 Act
Chapter 2 - The scope of a new Mental Health
Act
Is a Mental Health Act necessary?
Views of consultees
What the new Act should contain
Interaction with the Adults with Incapacity
(Scotland) Act
The name of the Act
Chapter 3
- Principles of the new Act
Introduction
Benefits of a statement
of principles
A framework for principles
Recommended principles
Applying
the principles
Alternative suggestions
Chapter
4 - Who would be covered by the new Act
Mental disorder in the 1984
Act
Retention of mental disorder
Alternative approaches
Mental Illness
Learning disability
Personality disorder
Exclusions
Changes
in category
Use of the Mental Health Act definition in other legislation
SECTION 2 COMPULSORY TREATMENT
Chapter 5 - Grounds
for compulsion
The current law regarding medical consent
Compulsory
treatment for mental disorder: current legislation
The basis for new criteria
Impaired judgement
Benefit from treatment
Risk
Treatability
Conclusion
Chapter 6 - Compulsory interventions
Current provisions regarding detention
Treatment and plans of care
Compulsory measures in the community
Our proposals for a community order
Role of the tribunal in compulsory intervention
Moving between hospital
based orders and community orders
Failure to comply with community order
Leave of absence
Community care orders
Chapter
7 - Initiating and approving compulsion
Role of relatives
Role
of general practitioners
Role of psychiatrists
Role of mental health
officers
Role of nurses
Chapter 8 - Duration,
reviews and appeals
Current legislative position
Detention under
current provisions
Nurse's holding power
Emergency detentions
Short
term detentions
Long term compulsory measures
The Mental Welfare Commission's
power of discharge
Discharge by the responsible medical officer
The
hospital managers' powers of discharge
The nearest relative's power of discharge
The relationship between emergency, short term and long term detention
Information and support for the patient
Chapter
9 - Forum for compulsory measures
Current statutory provisions
Sheriff court hearings
The tribunal system in England and Wales
Consultation
Key features of an improved system
Proposals for a new tribunal
Chapter 10 - Treatments and interventions requiring particular
safeguards
The current position
What makes treatments 'special'?
The safeguards for special treatments
Treatments which should require
consent and a second opinion (present s97)
Treatments which should require
consent or a second opinion (present s98)
Adding to the list of special treatments
The nature of the second opinion
The duration of the second opinion
Urgent treatment
Children and young people
Chapter
11 - Other provisions relating to patients subject to compulsion
Introduction
Transfer of patients within Scotland
Communications with
and by patients
Patients who are absent without leave
Searches
Sharing information regarding patients
SECTION 3 - RIGHTS OF USERS AND
CARERS
Chapter 12 - Rights of informal patients
Background
Incapable patients
'Coercive' voluntary admissions and
treatment
Restraint
Exceptional treatments
Chapter
13 - Service users' rights to assessment and services
Rights to assessment
Assessment of patients subject to compulsion
Assessment with a view
to compulsion and/or other services
Right to services
Reciprocity and
patients subject to compulsion
General rights to services
Inter-agency
working
Charging for services
Chapter 14 -
Individual and collective advocacy
Rights to individual advocacy
Rights to collective advocacy
Chapter 15 -
Advance statements
What are advance statements?
Current legal
effect of advance statements
Future legal force of advance statements
How the new system would work
Chapter 16 - Rights
of informal carers
Introduction
The nearest relative in the
1984 Act
Proposals for the 'named person'
Right to information and support
Carers' needs
Chapter 17 - Civil and social
rights
Voting rights
Housing and benefits
Stigma
Visiting
rights
Chapter 18 - Groups with specific needs
Physical and sensory disability
Children and young people
Gender
issues and the rights of parents with mental disorder
Ethnic minorities
SECTION 4 - SAFEGUARDS FOR VULNERABLE PEOPLE
Chapter
19 - Protection of vulnerable adults
Vulnerable adults
Ill treatment
and neglect
Protection for staff and carers
Obstruction
Vulnerable
witnesses
Chapter 20 - Police powers and responsibilities
Place of safety
Chapter 21 - Protection from
sexual exploitation and abuse
The current position
The need
for special legislation
A new framework
Problems with the general law
Sex Offenders Act
Chapter 22 - The regulation
of private hospitals
The regulation of private hospitals in the 1984
Act
The Scottish Commission for the Regulation of Care
The role of the
Mental Welfare Commission
SECTION 5 - THE MENTAL WELFARE COMMISSION
Chapter 23 - Mental Welfare Commission
Background
Composition of the Commission
Organisational arrangements
Accountability of the Commission
Role and duties of the Commission
SECTION 6 - OFFENDERS WITH MENTAL DISORDER
Chapter
24 - The legislative framework
Introduction
The interaction
of the Criminal Procedure (Scotland) Act and the 1984 Act
Chapter
25 - Unconvicted persons with mental disorder
Introduction
Diversion
from prosecution
Untried prisoners
Acquitted persons with recommendations
for mental health disposals
Chapter 26 - Convicted
offenders with mental disorder
Assessment of disposals
Remand
for inquiry into mental condition
Hospital orders
Interim hospital orders
Hospital directions
Guardianship
Probation with a condition of
treatment
Community orders
Transfer from prison to hospital
Treatment
in prison
Chapter 27 - High risk patients
Introduction
The MacLean Committee
Restricted patients
Ministers'
role in relation to restricted patients
Issues raised in consultations
Our proposals
Criteria for admission to the State Hospital
Appeals against
levels of security
Prisoners transferred to hospital with restriction directions
Chapter 28 -The Mental Health (Public Safety and
Appeals) (Scotland) Act 1999
Introduction
The provisions of
the 1999 Act
Our initial response to the legislation
Who does the Act
affect?
The public safety test
Entry and exit criteria
The 1999
Act and prisoners
Other provisions of the 1999 Act
Those a new Act will
not cover
Chapter 29 - Insanity and diminished responsibility
Background
Conclusions as to insanity
Diminished responsibility
Chapter 30 - Appropriate adults
The
appropriate adult scheme
Training
SECTION 7 - INTERNATIONAL AND CROSS
BORDER ISSUES
Chapter 31- Cross border issues
Transfer within the United Kingdom
Overseas patients
Chapter
32 -Hague Convention on the International Protection of Adults
The
Convention
Implications of the Convention for mental health law
Emergency
and short term detentions under the 1984 Act
Long term detentions and community
orders
Inter-country transfers
Chapter 33 -
European Convention on Human Rights and the Council of Europe White Paper on Psychiatry
The European Convention on Human Rights
Council of Europe White Paper
on Psychiatry and Human Rights
SECTION 8 - OTHER MATTERS
Chapter
34 - Regulations, research and other issues
Regulations
Statistics
and research
Forms
Training
Chapter 35
- The State Hospital
Statutory basis for provision and management
of the State Hospital
Chapter 36 - Code of Practice
The existing Code of Practice
The retention of a Code of Practice
A new Code of Practice
The Notes on the Act
Technological improvements
Chapter 37 - Implementation and monitoring of the
new Act
Implementation and Monitoring Group
Role of the group
Other groups currently in place
ANNEXES
Annex
1Summary of the Mental Health (Scotland) Act 1984, its history and comparison
with England and Wales
Annex 2Organisations and
individuals from whom consultation responses were received
Annex
3Note of places visited
Annex 4 Organisations
and individuals from whom oral evidence was taken
Annex
5 Consultation with users and informal carers
Annex
6 Special events
Annex 7 An evaluation of s18
of the Mental Health (Scotland) Act 1984 - Executive summary
Annex
8 Review of literature relating to mental health legislation - Summary
Annex 9 Scottish Law Commission, Report on Vulnerable
Adults - List of Recommendations
Annex 10 Mentally
Disordered Offenders and Criminal Proceedings
List
of recommendations |
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