Scottish mental health social workers face bigger workloads because of compulsory treatment legislation implemented in 2005.
A Scottish government-commissioned report on the Mental Health (Care and Treatment) Scotland Act 2003, published last week, also highlights the risks of a two-tier system of care with patients who are not detained receiving a poorer service.
The study found mental health officers (MHOs) spent much longer administering compulsory treatment measures than under earlier legislation.
The 2003 Act was seen as pioneering a human rights-led approach to mental health, providing a right to advocacy and creating the Mental Health Tribunal for Scotland to decide on long-term detention. This prevented users from having to go before the sheriff court to provide them with a less intimidating and more care-oriented atmosphere, and adequate recourse to challenge detention.
The report found that MHOs, who must apply to the tribunal for compulsory treatment orders, spend 20 hours on each order, 12 hours more than under the 1984 act. This was partly due to application forms being “significantly longer” and administration staff being overstretched. It also found that tribunals made a large number of interim CTOs, which last for up to one month, meaning practitioners had to attend several hearings before a full CTO could be granted.
MHOs and psychiatrists also warned that the increased amount of time they spent on compulsory work was compromising their work with those in voluntary treatment.
Ruth Stark, professional officer for the British Association of Social Workers Scotland, said: “The basic principles and concepts in the act are absolutely fine. The problems are that the processes that are in place to try and ensure that people’s human rights are respected have got in the way of delivering services.”
Shona Neal, chief executive of charity the Scottish Association for Mental Health, said her main concern was the creation of a two-tier system to the detriment of voluntary patients. But she said that the extra time spent on compulsory measures under the new act reflected the increased safeguards for service users.
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