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Heralded as the most radical shake up of mental health legislation in Scotland for 40 years by health minister Susan Deacon, new proposals launched last week have attracted only lukewarm support from campaigners.

The changes, published in a Scottish executive report and set to become legislation by early next year, are based on the recommendations of the Milan Committee which reported earlier this year and aim to balance rights and responsibilities of service users and carers.

Key proposals include compulsory treatment being tailored on an individual basis allowing, for the first time, some patients to be compulsorily treated in the community. An independent Mental Health Tribunal, chaired by a lawyer and comprising mental health and community care experts, is to replace Sheriff Court hearings on compulsory treatment.

Stronger rights for patients and carers are to be introduced, including additional duties on local authorities and health boards to develop advocacy services. Patients are to be given free legal representation and allowed to make advanced statements about their care at the new tribunals.

Launching the new proposals, Deacon said: "Patients and families will notice the difference. Today, we set out our proposals to bring mental health law up to date."

However, the Scottish Association for Mental Health greeted the proposals with mixed feelings. While welcoming the replacement of the Sheriff Court system, SAMH is disappointed that certain recommendations of the Milan Committee report have been dropped or diluted. "Although advocacy is supported, there is no right to advocacy as recommended by the Milan report," chief executive Shona Barcus said.

Of greater concern to SAMH are the proposals for compulsorily treating individuals living in the community. Barcus said the new community orders would force people to "take medication against their will" and would place other restrictions on their liberty, such as forcing them to live in a particular place. "Our worry is that fear of these orders could deter people from seeking the help they need, as well as how they will be enforced in practice," she added.

Renewing Mental Health Law from www.scotland.gov.uk