Alarm bells sound in Scotland at wider mental health role

Mental health officers in Scotland will have a greatly increased
role under the new Mental Health Act, with worrying implications
for practice.

I am a mental health officer for Edinburgh Council and have just
completed my initial training on the act. Without it I wouldn’t be
able to practise as a mental health officer from 6 October, when
the act comes into effect.

It is a laudable, much-praised and complex piece of legislation,
seeking to set up principles on the care and treatment of people
with mental disorder.

Implementation was originally scheduled for April and it is clear,
having done the training, why Scotland is not ready.

The work of mental health officers under the Mental Health (Care
and Treatment) (Scotland) Act 2003 will be different as the
legislation is not just a tweaked version of former
responsibilities.

People in mental health social work generally thrive on the
challenge of working to legislative frameworks. But this one will
be exceptionally demanding.

The act does show the value of the role of mental health officers
at a time when the executive is reviewing social work in Scotland.

It demands a great deal of mental health officers. This is in
contrast to proposals in the Mental Health Bill in England, where
the position of approved social worker is being undermined and
reduced.

Although delayed for six months, the training for the Scottish act
is going ahead. It has given us all a chance to see what the
legislation is about. Getting down to the detail is essential at
this stage.

From October, mental health officers should be consulted by medical
staff on all detentions, as the consent of relatives is no longer
needed. Mental health officers will also be responsible for
ensuring service users know their rights.

Services are to be delivered in the spirit of reciprocity. So, if a
person’s liberty is taken away by detention, there must be
reciprocal arrangements to improve that person’s mental health.
These should include support services, the right to advocacy and a
statutory adherence to an individual’s (and their carer’s) wishes
if they become mentally unwell. Setting up these arrangements
promises to be a tough challenge.

The act has 23 parts in 333 sections, with paperwork that quickly
reaches ceiling height.

For example, the mental health officer application form for a
compulsory treatment order is 27 pages long and asks exacting
questions of the practitioner in terms of care plan and treatment,
both in actual terms and perceived future needs for the service
user.

There are four manuals, known as readers, to accompany training.
The first is in the principles of the act – there is a whole day’s
training on these alone. The second is on emergency detention and
also includes short-term detention – now considered the least
likely option. The third is on compulsory treatment orders (with
its mammoth application form) and the new mental health tribunal.
The final tome is on criminal procedures. Alongside is a
comprehensive code of practice. All in all, plenty to read and much
to think about.