June 2017

1. The Mental Health Care and Treatment (Scotland Act) 2003 – A short guide to detention June 2017

2. Reason for detention • There will be occasions when a doctor is sufficiently concerned about someone that they will either bring them into hospital, or keep them in hospital, without their consent. This means the patient is detained (or ‘sectioned’). • The purpose of this is to allow the patient to be assessed in hospital to decide if they need medical treatment for a mental disorder.

3. A doctor may detain someone for the following reasons: • It is likely that they have a mental disorder. • It is likely their ability to make decisions about medical treatment is significantly impaired as a result of mental disorder. • It is a matter of urgency that they be kept in hospital to decide what medical treatment is needed. • That if they were not detained in hospital there would be a significant risk to themselves or others. • That arrangements for granting a Short Term Certificate would involve undesirable delay.

4. The Mental Health Act allows for people to be placed on different kinds of compulsory order depending on their circumstances There are two main kinds of compulsory powers used in General Hospitals: 1. Emergency detention – This would allow someone to be detained in hospital for up to 72 hours where hospital admission is required urgently to allow the person’s condition to be assessed. It will only take place if recommended by a doctor (FY2 or above) . Wherever possible, the agreement of a mental health officer (a social worker specially trained in mental health) should also be obtained. 2. Short-term detention – This would allow someone to be detained in hospital for up to 28 days. It will only take place where it is recommended by a specially trained doctor (a psychiatrist) and agreed by a mental health officer.

5. Conditions on use of MH Act There are strict conditions in the Act about when these powers might be used. These are: • That the person has a mental disorder. • Medical treatment is available which could stop their condition getting worse, or help treat some of their symptoms. • If that medical treatment was not provided, there would be a significant risk to the person or to others. • Because of the person’s mental disorder, his/her ability to make decisions about medical treatment is significantly impaired. • That the use of compulsory powers is necessary.

6. Cont... If someone is subject to an emergency detention, then they cannot be treated without their consent unless the treatment is required urgently, or they are being treated under another law called the ‘Adults with Incapacity Act’. Someone who is subject to short-term detention or a compulsory treatment order can be given treatment in accordance with rules set out in part 16 of the Act which deals with medical treatment. The definition of ‘medical treatment’ under the Act is quite wide. It means treatment for mental disorder and as well as medical treatments like drug treatments and electro-convulsive (ECT), it also covers nursing, care, psychological interventions, habilitation and rehabilitation. (‘Habilitation’ and ‘rehabilitation’ cover things like education and training in work, social and independent living skills.)