Current status: Answered by Maureen Watt on 9 November 2016
To ask the Scottish Government, further to the answer to question S5W-03411 by Maureen Watt on 26 October 2016, what its position is on whether people with mental health problems should have the same right to refuse treatment as people with physical health conditions.
Most people who use mental health services receive treatment without being subject to an order or certificate under the Mental Health (Scotland) (Care and Treatment) Act 2003. For some individuals however, compulsory treatment is used to provide the person with medical treatment to alleviate suffering and for the protection of both the person and others. Compulsory treatment is only allowed under mental health legislation in Scotland in very strict circumstances.
Firstly, certain criteria must be met before an order or certificate can be granted. For a 28 day short-term detention certificate (STDC), this includes that an approved medical practitioner considers it likely that the patient has a mental disorder (as defined by the 2003 Act) and that the patient’s decision making ability is significantly impaired by their disorder and without treatment the patient could be of significant risk to their own health, safety and welfare, or to the safety of others. The patient can appeal the granting of an STDC to the independent Mental Health Tribunal. A longer term order can only be granted by the Tribunal, and the application must have the support of two doctors who agree that the criteria for the order are met.
Secondly, treatment under the 2003 Act is governed by a range of safeguards. For certain treatments, including medication given for more than two months, a Designated Medical Practitioner, an experienced psychiatrist appointed by the Mental Welfare Commission, must agree to the treatment.
In addition to this, the 2003 Act is based in rights and principles and contains tools to support patients in expressing their will and preferences. The principles include that any function should be carried out for the maximum benefit of the patient, with the minimum necessary restriction on the freedom of the patient and having regard to the views of the patient and of any carer. Under the 2003 Act, any service user has the right to support from an independent advocate, the right to appoint a named person to represent their interests and the right to make an advance statement setting out how what treatment they would and would not like to receive when unwell