Detained mental health patients in Scotland are being treated without proper authorisation or consent, exposing a lack of training for staff in psychiatric wards.
That was the warning from watchdog the Mental Welfare Commission for Scotland in a report on compliance with part 16 of the Mental Health (Care and Treatment) (Scotland) Act 2003, which governs medical treatment. Twelve per cent of patients admitted compulsorily were receiving treatment that had not been properly authorised or recorded, the commission found following a series of unannounced visits to hospitals in 2010-11.
Problems included required forms authorising treatment being absent, not being completed lawfully or not giving authorisation for some of the medication that had been prescribed.
It found that 15% of patients certified as having given their consent to treatment were either unwilling or unable to give consent. These included cases where people did not believe they had a mental disorder or were not aware of the medication they were taking.
“It is not acceptable that people are being treated without proper authorisation,” said commission chief executive Dr Donald Lyons. “This part of the legislation exists to ensure that vulnerable people have appropriate safeguards if they are being treated without their consent. Managers must ensure staff are appropriately trained and find better systems and audits to improve compliance with the legislation.”
It called on the Scottish government and NHS boards to ensure that training for approved medical practitioners – psychiatrists approved to carry out certify compulsory treatment under the Act – addresses the shortcomings identified in the report.
It also said hospital managers should ensure regular audits of prescriptions and treatment forms are undertaken and that clinicians should ensure that consent to treatment is regularly reviewed.
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