Compulsory community mental health care hailed a success

Compulsory community mental health treatment in Scotland has benefited most service users, allaying fears that it would be used simply to enforce compliance with treatment.

That was the conclusion from a report today from the Mental Welfare Commission for Scotland into the use of community-based compulsory orders introduced under the Mental Health (Care and Treatment) Scotland Act 2003 to require people to engage with services but provide an alternative to hospital treatment.

The commission said many service users had raised concerns at the time that the powers would be overused or be simply employed as a tool to enforce compliance with medication.

However, of the 124 people on the treatment surveyed, 74 (60%) said the treatment order had benefited them and 31 people (25%) had mixed views. Just 19 people (15%) thought the order had been of no benefit.

The commission found that care plans were appropriately addressing the needs of people in almost all cases, finding 95% of the care plans satisfactory.

The commission was also pleased that 91% of cases had appropriate input from different agencies when care plans were reviewed and there was evidence of people participating in their own review meetings in 78% of cases.

Both service users and their carers had knowledge of what to do if they needed help and support in a crisis, with 84% of service users saying they knew what to do, the report said.

Housing was another area in which service users were content, with reviewers saying accommodation was meeting people’s needs in almost all cases. The commission added that service users were being well supported in any disputes. There were a number of cases in which service users did not accept housing support.

“In extreme situations the lack of housing support may place someone at risk of losing their tenancy and it was reassuring to see that in such circumstances strenuous efforts were being made to get the person to accept support to maintain their home, in the face of great resistance,” the report said.

Before the 2003 act was implemented, there were no provisions for compulsory treatment in the community, except under leave of absence from hospital.

Public health minister Michael Matheson welcomed the report and said it highlighted one of the key principles underpinning the act, that people should receive the least restrictive treatment possible.

“[Compulsory community treatment orders allow] people to continue their journey of recovery in their own homes while providing an important safety net for the care and treatment they need.”

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