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Mental Health Act (2003) reclaimed by service users and professionals at unique event in Dunfermline Press release issued by Fife Rights Forum, Citizens Advice and Rights Fife, NHS Fife and the Scottish Legal Aid Board Date: 21 February 2008 The full results of a multi-disciplinary event entitled “Reclaiming the Mental Health Act” have been published online today (Thursday, 21 February 2008) by The Fife Rights Forum in partnership with the Scottish Legal Aid Board’s Part V Mental Health Law Project, Citizens Advice and Rights Fife and NHS Fife. Covering many aspects of the mental health legislation, the results clearly document the discussions of a wide range of professionals and users of mental health services in Fife including individuals, carers and named persons. Issues covered include The Principles of the Mental Health (Care and Treatment) (Scotland) Act 2003, the tribunal process & procedure, advance statements, named persons, community-based compulsory treatment orders and the affect of mental health legislation on children and young people. Speaking about the event, Claudia Albrecht, the solicitor employed by the Scottish Legal Aid Board’s Part V Mental Health Law Project, and one of the event organisers, commented; “We were delighted that 110 delegates were able to join us at the end of November at the “Reclaiming the Mental Health Act” event in Dunfermline, contributing to what was a very positive and valuable, day-long meeting. Uniquely, the day provided an opportunity for both professionals and users to come together and share their views on aspects of mental health legislation, and to discuss commonly experienced benefits, problems and solutions. Many topics or aspects of the Act were made clearer and the event itself proved to be an excellent example of successful partnership working, aiming to improve the provision of a wide range of services for people with mental health problems in Fife”. Another of the event organisers, Sue Anderson from NHS Fife added; “Two years on from when the Act first came into effect, delegates had plenty to discuss and many varying opinions and experiences were considered. The four key speakers gave some extremely informative presentations and paved the way for very detailed discussions during the course of the day. Pleasingly there were many reports of positive change related to the implementation of the Act, but there were also areas identified that need further work, review or improvement”. The opening presentation was delivered by Geoff Huggins - Head of Mental Health Division, Healthcare Policy and Strategy Directorate and focussed on Mental Health Policy and Legislation. Mr Huggins suggested that; “Legislation is one of four key elements that will help to improve the care and treatment available to people in need of mental health services in Scotland today, and in the future. When you consider that an estimated 1-2million Scots are experiencing mild to moderate mental health problems, you get a real grasp of how far reaching this legislation is and therefore how important it is to continually review it and get it right”. He continued “I am glad to report that, on the whole, the implementation of the Mental Health Act has been effective and is delivering an appropriate framework for care and treatment. However there are still a number of areas needing further work and I would encourage anyone interested in the operation of the Act to engage with the ongoing consultation process that looks to present a series of recommendations to the Minister for Public Health aimed at improving efficiency of the operation of the Act as well as the overall experience of patients”. Dr Lyons, Director of the Mental Welfare Commission for Scotland, reported that “It was very valuable for the Mental Welfare Commission to be able to participate in the day’s discussions, particularly those that revolved around the Principles of the Mental Health Act. It would seem that the majority of people attending agreed that the Principles of the Act have made the Act itself more understandable and accessible to lay people and professionals alike. Furthermore it seemed to be the common consensus that these Principles do make a positive difference, encouraging accountability by professionals and giving clear expectations of what is required as well as guiding professionals on how to constructively review their own practice. He continued “However, discussions suggested that more work needs to be done to raise awareness of, and reference to, the principles on a regular basis. It was also noted that in some cases professionals may need additional guidance on how to apply the principles and to demonstrate that they have used them when making difficult clinical decisions”. Other aspects of the Act that were discussed include the new tribunal process, advance statements and named persons. When considering the tribunal process, delegates felt, in general, the benefits of the new tribunal process had exceeded the problems that some have encountered. The whole process was deemed as being more patient-centred and empowering. People were less intimidated, which in turn, had directly resulted in a better rate of attendance at tribunal hearings. Suggested improvements to the process included longer notice of hearing dates, more training and information and improved transparency as to how tribunal members are selected, how membership is reviewed and by whom. Discussions around the preparation of advance statements suggested that these statements were thought to be useful in giving practical force to the Act’s principles, by ensuring the wishes of the patient are stated and heard. Furthermore it was felt that advance statements held professionals more accountable, if they were to override the patient’s views. The very fact that these wishes could be overridden however, may have dissuaded some people from engaging with the process in the first place. It was noted that The Mental Welfare Commission’s role of robust investigation into such overrides was considered reassuring for patients, and was a role that should help to build trust into the advance statements process. The need to provide special arrangements to accommodate people with learning difficulties was emphasised and there was a lot of discussion over the responsibility associated with being a witness to an advance statement. There was some confusion over what could be included within an advance statement and discussion as to how statements be stored and updated. When discussing the system of named persons – where a named person has a role to play to help safeguard the patient’s interests – it was generally felt that the system was well regarded, but one that can be difficult to put into practice. Issues were raised about the lack of understanding and preparation of both professionals and the suggested named person, as well as low rates of consultation and poor planning. Time pressure, data management and rights of the individual versus rights of the named person, were also raised as being issues that often obstructed the nomination of named persons. Social inclusion was the theme for the final discussion topics, with delegates considering community-based compulsory treatment orders, as well as the affect of mental health legislation on children and young people. Norma Philpott, Chief Executive of Citizens Advice and Rights Fife was an active participant and reported that; “The discussions on community-based compulsory treatment orders (CCTOs) were extremely informative and there was general consensus that whilst CCTOs may not be ideal for everyone, treatment should be given in the community as much as possible. It was also suggested that in order to enhance the success of such orders, more consideration needed to be given to quality of life issues and community support services, as well as recognising individual patient needs and improving co-operation between members of the multi-disciplinary team, carers and patients”. She added; “The discussions pertaining to children and young people, highlighted the additional and different support needs youngsters have compared to that of adults. It was also noted that the differing definitions of childhood and adulthood, across and within, both the voluntary and statutory sectors can lead to problems in delivering an uncompromised care plan. Where possible, young people need to be empowered through better awareness and understanding of the key principles of the Act, with a view to helping and encouraging them to be more active participants in determining their needs and care”. Joe MacIntyre from Fife Rights Forum concludes; “The “Reclaiming the Mental Health Act” event has been undoubtedly, a resounding success. In allowing key members from across the mental health community in Fife to come together and discuss issues of importance and value, it has identified a need for more multi-disciplinary events, especially with input from the legal profession and from service users, carers and named persons. As a direct result of the event success and feedback from delegates, Fife Rights Forum has now put plans in place to facilitate two smaller multi-disciplinary training events per year that will cover mental health related topics and allowing for information and views to be exchanged. The first one of these events is scheduled for May 2008 and, it is anticipated, will pick up on matters and training needs identified by “Reclaiming the Mental Health Act”. For full details on the event and future plans, please visit www.fiferights.org/mhlf -ENDS- FOR FURTHER INFORMATION CONTACT : Claudia Albrecht Sue Anderson EDITOR’S NOTES
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