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Monday, February 22, 1999 Published at 17:40 GMT


Fears over imbalance in mental health review

Patients need more rights, say mental health campaigners

Changes to mental health legislation in Scotland is in danger of being hijacked by fears about psychopaths and compulsory treatment, a mental health charity has warned.

The Scottish Association for Mental Health says there is a danger that discussions will focus solely on negative aspects of mental disorder rather than on the need for patients to be given more rights.

Scottish health secretary Sam Galbraith announced the remit of the review on Monday.

It will cover everything from the definition of mental disorder to arrangements for the sentencing and treatment of serious violent and sexual offenders.

Mr Galbraith said the review was necessary because "since the Mental Health (Scotland) Act 1984, there have been significant changes in the way that mental health services are organised".


It will cover:

  • The definition of mental disorder;
  • The criteria and procedures for detention in and discharge from hospital;
  • Leave of absence and care outside of hospital;
  • The role of the Mental Welfare Commission in Scotland;
  • The findings of the committee set up to review arrangements for the sentencing and treatment of serious violent and sexual offenders, including those with personality disorders.

Mr Galbraith also announced the make-up of the review committee, which will be chaired by Bruce Millan, the former Scottish secretary.

A spokesman for the Scottish Association for Mental Health (SAMH) said he was worried the review would not be "reciprocal" and would focus mainly on compulsory treatment for community care patients and the treatment of psychopaths and sex offenders.

"There needs to be reciprocity of care. If patients are being detained and given compulsory treatment, they should have rights, for example, to a minimum standard of care and independent advocates.

"They should also have the right to be informed about their treatment so they can take part in decisions over it," he said.

"There is a danger that this review will be hijacked by arguments over compulsory medication which is a knee-jerk reaction to public fears about the mentally ill."

Compulsory treatment

The association does not support compulsory treatment and says Scotland already has community care orders which allow for people who do not take their medication in the community to be taken into hospital for reassessment.

It wants to see modern legislation which reflects changes that have been made since the last major mental health legislation was pushed through in 1960.

These include changing attitudes to patients' needs and rights.

He also called on the committee to consult widely with patient groups and carers, saying it appeared to be heavily weighted towards health professionals.

[ image: Sam Galbraith has announced the remit of the mental health review]
Sam Galbraith has announced the remit of the mental health review
In a recent report, the Scottish Mental Welfare Commission raised concerns that doctors were giving patients' treatments which required their consent when they had not given it.

The SAMH says the review should look at the issue of consent. The spokesman said, for example, that there should be a debate over whether treatments like electro-convulsive therapy should be given without patients' consent.

Mental health legislation is also being overhauled in England and Wales. An announcement is expected in the summer.

In advance of the review, Home Secretary Jack Straw announced proposed changes in the treatment of psychopaths last week.

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