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The purpose of this paper is to investigate the use of the Mental Health (Care and Treatment) (Scotland) Act 2003 for people with learning disabilities in Scotland, in the context of the recent commitment by the Scottish Government to review the place of learning disability (LD) within the Act.

All current compulsory treatment orders (CTO) including LD as a type of mental disorder were identified and reviewed. Data was collected on duration and type of detention (hospital or community based) for all orders. For those with additional mental illness and/or personality disorder, diagnoses were recorded. For those with LD only, symptoms, severity of LD and treatment were recorded.

In total, 11 per cent of CTOs included LD as a type of mental disorder. The majority of these also included mental illness. The duration of detention for people with LD only was almost double that for those without LD. A variety of mental illness diagnoses were represented, psychotic disorders being the most common (54 per cent). Treatment was broad and multidisciplinary. In all, 87 per cent of people with LD only were prescribed psychotropic medication authorised by CTO.

There has been limited research on the use of mental health legislation for people with learning disabilities. This project aids understanding of current practice and will be of interest to readers both in Scotland and further afield. It will inform the review of LD as a type of mental disorder under Scottish mental health law, including consideration of the need for specific legislation.

The purpose of this paper is to describe the evolution of legislation relevant to people with intellectual disabilities (IDs) since the Scottish Parliament came into being in 1999; this will be particularly relevant to practitioners working with people with IDs within mental health and forensic mental health services.

A descriptive review of the relevant legislation, setting this out in the chronological order in which the legislation was enacted.

The paper demonstrates that legislative reform is a dynamic and evolving process, responsive to social, political and legal agendas.

The paper is limited to a description of the relevant legislation in only one part of the UK (Scotland).

A helpful summary of the relevant legislation is provided which should be of particular value to readers/practitioners from outwith Scotland.

The paper provides an up to date account of the legislative reform in Scotland during the period 1999-2015.

Previously, diversion from the criminal justice system for people with learning disability (LD) and serious forensic needs in Scotland meant hospitalisation. More recently new legislation has meant that community-based rehabilitation is possible for this group. The purpose of this paper is to qualitatively explore the views of people with LD subject to these legal orders. This is both a chance to work in partnership to improve services and also to make the voices of this potentially vulnerable group heard.

Semi-structured interviews were conducted with ten participants subject to a community-based order. All participants were male. Ages, index behaviour, and time spent on order varied. The data was transcribed and analysed using interpretative phenomenological analysis.

The main themes which emerged from the data were a taste of freedom, not being in control, getting control back, loneliness, and feeling like a service user. Participants described positives about community-based rehabilitation but also a number of negatives.

Participant accounts suggest that the current community rehabilitation model has some shortcomings which need to be addressed. Suggestions are made for improvements to the current model relating to: achieving clarity over the role of support staff and pathways out of the system; increasing opportunities for service users to voice concerns; empowering staff teams via extensive training and supervision; and directly addressing internalised stigma to promote community integration.

This is the first piece of work evaluating compulsory community forensic care for people with LD from the perspective of service users. It highlights difficulties with the system which could lead to helpful ways to evolve this model.

We describe how Supervised Discharge (Section 25) of the Mental Health Act 1983 was used to promote mental health care in the community for a man with mild learning disabilities and paranoid schizophrenia who has had repeated relapses and hospital admissions. The new compulsory Community Treatment Order in England and Wales introduced by the Mental Health Act 2007 is explored in comparison with Section 25 Supervised Discharge, which it has now replaced, and compared with similar legislation already introduced in Scotland. The practice implications of the new supervised community treatment orders are discussed.

This paper aims to set out the views of approved mental health professionals (AMHPs) on the impact of supervised community treatment (SCT) on their work and their patients' lives in the community.

The study covered a total of 56 community treatment order (CTO)‐related activities undertaken in 2010 in a local social services authority (LSSA) in the north west of England, and looked at data from the records of 25 CTO patients. Nine AMHPs responded to a CTO outcomes questionnaire and five participated in a focus group.

The characteristics of CTO patients in this LSSA study were consistent with national data. AMHPs were often undecided about the benefits of CTOs to their patients. A majority agreed that CTOs could benefit patients by earlier identification of relapse, improving access to housing and reducing the risk of avoidable harm to self or others. However, a majority also agreed that CTOs had not improved patients' access to employment, education, training or recreational activities; nor had they helped reduce the stigma and discrimination that patients faced.

This was a relatively small‐scale study. However, its findings are consistent with previous work in this area, and provide pointers to how SCT can be more effectively implemented across England.

There is very little published research into the impact of SCT in England. Although small in scale, this study provides valuable insights into the views of AMHPs, who play a core role in the CTO process.

The new Mental Health Act 2007 substantially amends the Mental Health Act 1983. In this article, some of the most important changes are highlighted, including changes to the definition of mental disorder, the new professional roles of approved mental health practitioner and responsible clinician, and the new powers for Supervised Community Treatment. The likely impact of these changes for people with learning disability and professionals working with them is discussed.

The UK government's Mental Health Act 2007 introduces compulsory supervised community treatment (SCT) to England and Wales. Estimates of the possible level of use of SCT are helpful both to address patient fears and to plan services. The number of patients under SCT is likely to rise over time, although the level of use will depend on a number of contextual variables and whether evidence of clinical and social benefits is forthcoming.

This paper explores the perspectives of patients subject to supervised community treatment (SCT) within two mental health teams in Merseyside.

A structured survey tool was developed to explore patient perspective. In total, 17 patients agreed to participate in the study subject to informed consent.

The majority of patients believed SCT facilitated early hospital discharge but felt uninvolved in the process. A significant proportion lacked the motivation or ability to understand the verbal and written information pertaining to their legal rights at the time it was given, usually immediately prior to hospital discharge. All felt they must strictly abide to the SCT conditions to remain in the community. There was a lack of knowledge about the harm criteria and the responsible clinician's ability to recall a service user to hospital even if they abided by the conditions.

This study is based upon a small sample size. There is no attempt to generalise the results.

There have been few studies exploring the perspective of patients subject to SCT. A fuller awareness and understanding of patient perspective is important to promote involvement and therapeutic outcomes.

Over the last 12 years there have been substantial developments in UK law and policy relevant to mental health social work practice. The previous legal frameworks across the jurisdictions were very similar but the new laws have developed in different ways and provide greater opportunities for comparison. Across all the jurisdictions policy developments, especially in the areas of recovery and risk assessment, have influenced the way that mental health social workers practice.

This exploratory study used case study vignettes with 28 respondents to examine how these major legal and policy developments impact on social work practice.

There were variations in how levels of risk are defined and often a lack of clarity about how this informs decisions. There was a consensus that recovery is important but difficulties in understanding how this might apply in crises. Predictably, differences in legal and policy contexts meant that there were a variety of perspectives on how mental health social workers applied the laws in their jurisdictions.

The limited focus on research informed practice and the lack of transparency in decision making across areas of risk assessment and intervention, use of recovery approaches and the use of mental health laws suggest the need for a more evidence-based approach to training, education and practice.

There is very limited previous research on practitioner experiences of the complexities involved in implementing mental health law. This paper provides some insights into the issues involved and for the need for more detailed examination of the decision-making processes involved.