The New Mental Health Act: Putting Principles into Practice - Information for Service Users and their Carers

3 What do the principles say?

The principles say that whenever a professional involved is making a decision about your care and treatment under the Act he or she should:

• Take your past and present wishes into account
  
  Professionals should work with you to find out what care and treatment options you think might be right for you. If you are very ill it might be difficult for you to be involved or to make your views clear. The Act has put in place several arrangements that aim to help you
  a) Your named person is someone who should be given information and can be involved in decisions about your treatment and care. This can be someone that you choose, or it can be your primary carer or nearest relative. There is a separate guide which explains named persons in more detail.
  b) Your advance statement can be made while you are well. It is a written statement setting out what treatment you would, or would not, like to receive in future. If someone involved in your care and treatment makes a decision that goes against your advance statement you will be informed in writing of the reasons for this. The Mental Welfare Commission will also be informed and may investigate further. There is a separate guide which explains advance statements in more detail.
  c) Your right to access independent advocacy services is set out in the Act. If you are being treated under the Act you have the right to access an independent advocate. Independent advocacy can help you to make your views heard. There is a separate guide which explains independent advocacy in more detail.

• Make sure you get the information and support you need to take part in decisions
  
  You should be supplied with the information and given the support you need to participate as fully as possible in decisions. This might mean that information should be in a form you can understand. If you have communication difficulties and need help (for example translation services or signing) this should be looked into. Services have certain legal duties to provide you with the support you need to access services under both the Race Relations Act and the Disability Discrimination Act.

The voice of experience

"I felt I wasn't consulted on what I thought was best for myself. I don't know if it was because I was just 18, but I felt like a silly wee lassie that needed to get sorted out. There was one nurse who treated me as an equal, which was so refreshing. I knew that I could say whatever I was thinking, whatever I was feeling and I wasn't going to be made to feel silly. His attitude toward me was what I would have hoped everyone else's attitude was going to be."

• Take the views of your carer, named person, guardian or welfare attorney into account
  
  The people who know you well, or may help to look after you should be involved in decisions about your care and treatment. They should be given the information and support that they need to support you.

• Look at the full range of options for your care
  
  Professionals involved in your care should look into what treatment options and services are available and should match these to your individual needs. Your care and treatment should not restrict your freedom any more than is necessary to keep you safe. When you stop being treated under the Act, you should continue to receive care and treatment for as long as is necessary.

The voice of experience

"I'm one of the very fortunate people who receives support in the community. Prior to leaving hospital I was put onto a 'supporting people in the community care plan'. This has been really successful for me. After several years of being in and out of hospital, eventually resulting in my children being taken into care, I have had 7 successful months which I expect to continue. I just wish it had happened earlier."

• Give you treatment that provides maximum benefit
  
  Being treated under the Act can mean that you are kept in hospital against your will, given treatment that you haven't consented to, or made to take part in particular activities. In exchange for removing some of your freedom, the people involved in your care have a duty to make sure that you get the care and treatment that is of maximum benefit to you.

The voice of experience

"If I hadn't been put onto a section I don't think I would be here today. I reckon I would definitely have gone on to commit suicide. Although I can't say it was a positive experience it probably was a necessary one."

• Take account of your background, beliefs and abilities

The principles support a way of working that promotes respect for you as an individual. People involved in your care and treatment should take account of who you are, your abilities, your cultural or ethnic background and your beliefs.

• Make sure that any restrictions on your freedom should be the 'minimum necessary in the circumstances'

Treatment under the Act might mean that some of your freedom of choice or movement might be restricted. The law says that this freedom should not be restricted any more than is necessary to keep you safe.

The voice of experience

"The problem is that often we know when we are getting ill and often we ask for help but don't get it when we feel that we desperately need it. We need to acknowledge ideas such as prevention, self-help and recovery. We need a range of services that will support us in the community and at home; to give us as good a quality of life as possible and to help reduce the regular descent into illness so many of us face."

• Make sure that you are not being treated less favourably than other patients

The fact that you are being treated under mental health law should not affect the quality of care and treatment that you receive.

The voice of experience

"I don't think I was treated in the same way as I would have been if I had been in an ordinary hospital."

• Your carers' needs are taken into account and they get the information and support they need to help them care for you

Carers should be consulted and involved in decisions about the care and treatment you receive from service providers, provided you are happy for them to be involved. Professionals need to balance the importance of informing, consulting and supporting carers with your right to confidentiality. You can say if there is some information about your illness or treatment that you don't want to be shared with your carer. Unless there is serious risk of harm to yourself or others you have the right to confidentiality.

The voice of experience

"After five and a half months in hospital you definitely need support when you come home. And it wasn't just me who needed support but the family I was staying with needed help to understand how I was feeling. They needed reassurance that what they were doing was OK."

• Take special care of your welfare if you are under 18 years of age
  
  If you are a child, or young person under the age of 18, people carrying out duties under the Act must try to make sure that they are putting your welfare first. This might mean helping you to access services that have been designed to meet the needs of children and young people.