We are testing a new beta website for gov.scot go to new site

Reforming Mental Health Law Newsletter

DescriptionImplementation of new mental health law - information and news updates
Official Print Publication Date
Website Publication DateJune 19, 2003



    This document is also available in pdf format (80k)

    Welcome to the first edition of the Scottish Executive's newsletter, 'Reforming Mental Health Law'.

    The purpose of this newsletter is to keep you in touch with work to implement the new Mental Health (Care and Treatment) (Scotland) Act 2003, which received Royal Assent on 25 April.

    The new Act is a milestone in mental health law, and should bring real benefits for people with mental health problems in Scotland, and those who care for them. It promises to make a major contribution to achieving the ultimate objective of mental health law - to make sure people with mental health problems can receive effective care and treatment, in a way which accords with the Millan principles (see box below.)

    But there is a great deal of work to do before the Act can be brought into effect - in other words, to implement the new Act.

    This newsletter:

    • briefly introduces some of the work the Executive will be taking forward to implement the new Act and to support service development, to make sure the benefits the Act promises are achieved in reality; and

    • invites views on when we should aim to bring the Act into effect.

    More information on implementation process, on service development, and on the provisions of the Act, will be given in 'Implementing the Mental Health (Care and Treatment) Act - What you need to know', which will be published shortly.

    Later newsletters will keep you up to date with progress on implementing the new Act. We hope you find this first edition useful, and would be grateful for any comments you have.

    We all face a great deal of work in bringing this new Act to fruition: but there is a very significant prize to be achieved. We look forward to working with you to achieve it.

    In this Issue

    The new Act - where to get it
    Implementing the new Act
    The new Act - what's it about?
    Developing services
    When should the new Act come into effect?
    Getting in touch
    Coming soon - further information on the new Act

    The new Act - where to get it

    The Mental Health (Care and Treatment) (Scotland) Act 2003 is available online at www.scotland-legislation.hmso.gov.uk

    A print version is also available to purchase from The Stationery Office Bookshop, 71 Lothian Road, Edinburgh and at outlets across the United Kingdom, or online at www.tso.co.uk/bookshop .

    Braille copies of this Act can be purchased at the same price as the print edition by contacting TSO Customer Services on 0870 600 5522 or by e-mail: customer.service@tso.co.uk

    Implementing the new Act

    The Scottish Executive is taking forward a number of strands of work to implement the Act. These include:

    • setting up the new Mental Health Tribunal for Scotland. Under the new Act, members of this independent body will make decisions in a wide range of situations, including whether someone should be compelled to accept treatment for mental disorder where certain strict criteria are met. The Tribunal will need to be expert in both mental health law and mental health services, to make sure the Millan principle of reciprocity is fairly applied;

    • developing a Code of Practice and other information on the new Act. Professionals who carry out functions under the Act will need to have regard to this Code of Practice in doing so. We also want everyone who comes into contact with the Act to be clear about how it works and what their rights are;

    • supporting arrangements for training on the new Act. The Executive will work with employers, professional bodies and staff to develop effective arrangements for training on the new Act, including the development of training materials;

    • developing arrangements for monitoring, assessment and research, to make sure we know how the new Act is working, whether its objectives are being achieved, and what we could do to make it work as well as it possibly can. A consultation paper on an initial research programme has already been issued, and is available from our website;

    • in some areas, developing and making secondary legislation (such as Regulations) to fill in the details of the legal framework; and

    • raising awareness of the new Act.

    More information on the implementation process will be given in 'What you need to know', and on the Mental Health Law website (address below.)

    The new Act - what's it about?

    The Mental Health (Care and Treatment) (Scotland) Act 2003 covers four main areas:

    • it places a range of duties (and gives a range of powers) to organisations involved in mental health law, including mental health service providers, the Mental Welfare Commission, and the new Mental Health Tribunal for Scotland;

    • it defines clear procedures for decision-making on the compulsory treatment and/or detention of people with mental disorder. It sets criteria which have to be met before compulsion can be authorised;

    • it amends existing criminal justice legislation to give courts more effective ways of assessing and dealing with a person with mental disorder who comes before them. And it defines procedures for the review of orders made by a court in relation to a person with mental disorder;

    • it provides a range of new rights for people with mental disorder, such as a right of access to advocacy services; and it provides safeguards on the use of certain medical treatments.

    Developing services

    The new Act will have significant implications for the delivery of mental health services. Additional resources are being made available, but the Executive recognises the challenges services face in preparing for the coming-into-effect of the new Act.

    The Executive therefore commissioned a national assessment of mental health services, in light of the new Act. A team led by Dr Sandra Grant is now in the midst of this assessment. Their report will be published in the autumn. The Executive will consider what further steps are needed to support service development, to ensure that the Act can deliver the benefits we all seek.

    When should the new Act come into effect?

    We need to decide on a firm target date for the coming-into-effect of the Act. This is for Ministers to decide, but they want to know your views. People have made a number of suggestions to us already, for example:

    • we should bring the Act into effect as soon as it can safely be done, so that its benefits are achieved as soon as possible;

    • the new system, including the Tribunal, will have to work effectively from day one;

    • there is a significant amount of work to do in reconfiguring and increasing the capacity of services before the Act can safely be brought into effect;

    • having set a date, it would be very costly to change that date nearer the time, because of the amount of training which will need to be arranged; and

    • it would be possible to bring some sections of the Act into effect before others.

    Taking these ideas into account, we would welcome views on the following proposal:

    • we should aim to bring the main provisions of the Act into effect on 1 April 2005;

    • we bring into effect some self-contained provisions (such as those relating to the making of advance statements and the nomination of named persons) on 1 October 2004.

    It is very important that we receive as wide a range of views as possible on the target date for coming-into-effect, after which we will announce a target date. Comments by Friday 25 July would be very welcome (contact details below.)

    Getting in touch

    To comment on this newsletter, the coming-into-effect date, or any other aspect of implementing the new Act, please contact:

    Mental Health Act Implementation Team

    Scottish Executive Health Department
    St Andrew's House, 3EN
    EH1 3DG

    e-mail: mentalhealthlawmailbox@scotland.gsi.gov.uk
    website: www.scotland.gov.uk/health/mentalhealthlaw

    The Millan principles

    These principles were set out by the Millan Committee in their report 'New Directions'. While the principles have no legal effect of themselves, the new Act will give legal effect to some aspects of these principles - those which could be legally defined. More generally, however, the Millan principles remain the basis of Executive policy on mental health law, and provide a picture of how mental health law should work.

    Non-discrimination - people with a mental disorder should, wherever possible, retain the same rights and entitlements as those with other health needs.

    Equality - all powers under the Act should be exercised without any direct or indirect discrimination on the grounds of physical disability, age, gender, sexual orientation, language, religion or national, ethnic or social origin.

    Respect for diversity - service users should receive care, treatment and support in a manner that accords respect for their individual qualities, abilities and diverse backgrounds and properly takes into account their age, gender, sexual orientation, ethnic group and social, cultural and religious background.

    Reciprocity - where society imposes an obligation on an individual to comply with a programme of treatment and care, it should impose a parallel obligation on the health and social care authorities to provide safe and appropriate services, including ongoing care following discharge from compulsion.

    Informal care - wherever possible care, treatment and support should be provided to people with mental disorder without recourse to compulsion.

    Participation - service users should be fully involved, to the extent permitted by their individual capacity, in all aspects of their assessment, care, treatment and support. Account should be taken of both past and present wishes, so far as they can be ascertained. Service users should be provided with all the information and support necessary to enable them to participate fully. All such information should be provided in a way which renders it most likely to be understood.

    Respect for carers - those who provide care to service users on an informal basis should receive respect for their role and experience, receive appropriate information and advice, and have their views and needs taken into account.

    Least restrictive alternative - service users should be provided with any necessary care, treatment and support both in the least invasive manner and in the least restrictive manner and environment compatible with the delivery of safe, effective care, taking account where appropriate of the safety of others.

    Benefit - any intervention under the Act should be likely to produce for the service user a benefit which cannot reasonably be achieved other than by the intervention.

    Child welfare - the welfare of a child with mental disorder should be paramount in any interventions imposed on the child under the Act.

    Coming soon

    A range of further information on the reform of mental health law will be published shortly:

    • 'Implementing the Mental Health (Care and Treatment) Act - What you need to know'. To be published shortly, this will restate our objectives for mental health law, provide more detail on the implementation process, and summarise the provisions of the new Act;

    • Initial guidance for mental health service providers will also be published this summer. This will confirm the target date for coming-into-effect, and set out milestones for the planning and development of services up to that date.

    • Explanatory Notes on the Act will be formally published by HMSO later this year.