Mental Health Act Review – Mental Welfare Commission response

 Mental Health Act Review – Mental Welfare Commission response

‘A great opportunity; a chance to re-frame Scotland’s legislation in such a way that the human rights of people with serious mental illness are clearly at the centre.’

The Mental Health Act in Scotland is currently under review, and the Commission has just published its response to the Independent Review of Scottish Mental Health Law consultation.

The Commission has a statutory duty to monitor the use of the Act, and a duty to provide advice on the use of the Act. 

This response is informed by the Commission’s own experience of meeting those duties and responsibilities. It is also informed by people with mental illness and relatives/carers who have shared their experiences with the Commission.

Key points

Key points from the Commission’s response to the consultation include:

  • Scotland’s health and social care systems are substantially different from those that were in place in 2003 when the current Mental Health Act was passed by parliament. The new Act needs to take account of these changes.
  • People are more likely to be treated in the community, rather than in hospital, and the resources, support and care available in the community should be reviewed. We raise specific points in our response for those who are detained under the Act and also for those who are not detained but may need specific care such as children and young people, people with a diagnosis of personality disorder and perinatal mental health services.
  • The number of people being detained under the current Act rises every year. In order to make the right decisions for the future, the review needs to analyse, at an early stage, why this is happening.
  • The lengths of time people are detained, and the safeguards in place when they are detained, should be examined. We find that many detentions run for the maximum length of time allowed by the law, and those lengths of time have not changed for decades. We believe they could be shortened. 
  • The review should take account of developments in international law to ensure we can learn from other nations and should incorporate the UN Convention on the Rights of People with Disabilities.
  • While reviewing the Act is vital, it will only be effective if mental health services are adequately resourced. We ask that resources are considered at all key stages of the review.

From a lived experience and relative/carer’s perspective, issues include:

  • The current Act is clear about professionals’ roles, and detained patients’ rights; it provides safeguards and guidelines. However it does not work for everyone who has mental health issues but who is not subject to the law; those people do not have the protections the Act offers.
  • Resources are scarce, the lack of community support often leaves families trying to support the individual with limited knowledge and resources of their own.
  • Children and Adolescent Mental Health services (CAMHS) are stretched to the limit. While much work is being done in education services related to mental health and well-being, the systems for supporting a young person with a serious mental illness are unwieldy and inefficient, if present at all.
  • GPs sometimes struggle to get help for individuals with mental health issues often because of the lack of resource available to community mental health teams. Better communication between primary and secondary care and more seamless access to assessment would greatly improve the management of these individuals in the community.
  • This legislation is complex, and our response addresses many more issues. We encourage audiences to read it in full and ask us for further clarity or information.

Dr Arun Chopra, medical director, Mental Welfare Commission, said:

“We had been calling for a substantive review of this legislation for some time, and we very much welcome the Review’s aim to improve the rights and protections of people who may be subject to the law when receiving care and treatment.  

“Mental health legislation can restrict and deprive a person of their liberty and can impose treatment that they do not want or cannot consent to. Traditionally one purpose of legislation was to ensure that people who are unwell are treated to restore them to health and reduce any risks that their altered state of health might pose to their safety and that of others. A further purpose was to ensure that when someone is made subject to detention or treatment that they cannot or do not consent to, that there is a mechanism for this detention to be reviewed, and safeguards are in place to ensure that people are treated in accordance with their human rights. 
“Developments in International law would suggest that a Mental Health Act ought to go further and focus on the restoration of other rights that are impinged on by the presence of disability (such as serious mental illness). 

“The Review of Scotland’s Mental Health Act gives us a great opportunity to fully consider those developments, alongside the UN Convention on the Rights of Persons with Disabilities which came into force after our current Act. 

“Scotland’s legislation can be re-framed in such a way that the human rights of people with serious mental illness are clearly are the centre.’

‘While reviewing the Act is vital, it will only be effective if it is adequately resourced. We ask that resources are considered at all key stages of the Review.”

The full Commission response to the consultation can be read here.

The Commission will be seeking opportunities to discuss and share this response with others over the coming months.

Dr Chopra added: ‘The Commission would like the review to consider how a new Act might give emphasis so that any action taken under Act must be proportionate and that there is a duty of reciprocity to ensure that people who are subject to the Act or who have been, are able to receive the support and services they need for their recovery.’

Listen to Dr Chopra’s summary here (4 mins, audio)

The Mental Welfare Commission for Scotland
Thistle House
91 Haymarket Terrace
Edinburgh EH12 5HE

Welcome to Haddstock at Home!

Beki Dover, Director of Haddstock, writes…

Haddstock music and arts festival is moving online as a series of video events. We will use facebook/haddstock and our website www.haddstock.co.uk as platforms. Keep checking in as the line-up is being added to daily in the run-up to Haddstock at Home. Haddstock proper has been postponed until Sat 26th + Sun 27th Sept 2020.

Haddstock at Home that will take place on 30th + 31st May on social media and our website. The weekend will consist of live music videos recorded by some of our musicians during lockdown, album release exclusives and our main stakeholders including Art Point, ELPA, Low Impact Living, MADE in East Lothian, YMI/ Oi Musica as well as artists and performers are providing music and art activity videos. We will also post art and an authors’ interview/ writing process zoom video. We are encouraging families to create a festival arena in their homes and gardens and we’ll ask the public to nominate a community hero who will be given a locally produced gift from Haddstock. 

Our aim is to produce an online event at this stage that represents what we have set out to achieve and utilises 6 months of planning. We have a diverse range of stakeholders and contributors who need a platform at this difficult time and we hope that people at home will benefit from entertainment and creative inspiration.  

Hope you will join us next weekend.

With best wishes 

Beki 

Beki Dover
Director
Haddstock 2020
07834 981631
haddstock@gmail.com
www.haddstock.co.uk

Update on Dementia Friendly walks in East Lothian

By Parvine Jazayeri

As we are going through some uncertain times, I thought it would be good if I shared some positive news with you all.

Over the past year, Ageing Well has been working very hard on a new project initiative – Dementia Friendly (DF) Walking. As most of you will already know, we run 10 Health Walks in East Lothian. To make our walks even more inclusive, we wanted to ensure everyone and anyone could access our walks. This was when Paths For All asked if we would be interested in introducing Dementia Friendly Walks – ofcourse I said yes. What does this mean? Basically, I have been through Cascade DF Walk Leader Training which has allowed me to train my Volunteer Walk Leaders. With more training, we have been able to adapt our walks, to ensure we are being inclusive. I have also had to create a Portfolio showcasing what we have done over the past year to grant us our accreditation. I have carried out consultations with DF groups, worked closely with new partners such as Alzheimer’s Scotland, worked closely with our Marketing Teams and so forth (the list goes on).

As you can see it has been a busy year but the hard work has paid off – we were awarded our accreditation this week!!! This is such a great achievement for the Ageing Well Project and we look to expand on this by have some Macmillan Move More Health Walks too.

I just want to say a massive thank you to everyone who has supported this project, especially the Walk Leaders – we could not have done this without you!

I would be grateful if you could share this good news story and although our Health Walks may not be operating at the moment, I hope you are all able to find some time to enjoy a walk close to your home.

Thank you and stay safe.

Parvine

Parvine Jazayeri | Ageing Well Co-ordinator

Meadowmill Sports Centre | Off the B1361 | By Tranent | EH33 1LZ | t: 01620 827240 | m: 07718 117585  | www.eastlothian.gov.uk | www.activeeastlothian.co.uk

National Walking Month

These people may not be two metres apart but they are from the same household 🙂

As some of you might already know, today marks the first day of National Walking Month, so this email has come at a good time.

Paths For All have kindly created a short newsletter and a 30 day wellbeing challenge (see bottom of this article) to help us keep in touch with our walkers and volunteers to keep everyone motivated while we can’t meet up to walk. See newsletter here.

I hope these are useful to some people and please feel free to share these attachments with your walkers, friends and family.

Parvine Jazayeri
Ageing Well Co-ordinator
Meadowmill Sports Centre
Off the B1361
By Tranent
EH33 1LZ
t: 01620 827240
m: 07718 117585 
www.eastlothian.gov.uk
www.activeeastlothian.co.uk

Appeal for donations of mountain bikes & bike equipment for young people with ELC’s 15+ Aftercare Team

The three bikes Davie, Owen and the team have refurbished so far

East Lothian Council 15+ Aftercare Team is seeking donations of mountain bikes asap for young people aged 16-26 who are who use ELC’s aftercare service (having been in residential or foster care). This will help young people during the current COVID19 restrictions to exercise and where necessary travel for shopping without having to use public transport. We hope that this will also help promote better physical and mental wellbeing for many of the young people who are isolated in tenancies or emergency accommodation.

Donations of working bikes for young adults (heights 5 foot – 6 foot) gratefully received! Thanks for donations already received. We still need a further 11 bikes (10 male, 1 female).

If you have a bike to donate, here’s what to do

If you have a suitable bike or equipment to donate, please email a photo of it to Davie Rutherford, ELHSCP Community Payback Team Leader at drutherford@eastlothian.gov.uk or call or text him on  07776 170 478 

Davie or ELC colleague Anne Landsburgh from the 15+ Team will arrange to view the bike and organise collection or drop-off of the bikes, in line with the appropriate health and social distancing guidance.

The bikes will be checked over and any necessary repairs carried out by Community Payback Work Supervisor and qualified bike mechanic Owen McAlpine.

Paul Huish, Club & Community Sports Development Officer and team colleagues are also assisting with sourcing bike offers – it is great to have enthusiasm and offers of help from across the Council.

We need cycling equipment too

The young people also require donations of bike locks, working lights, helmets, and repair kits so if you have any to spare, please contact Davie at the email or number above.

East Lothian Community Hospital cycle path survey

ELHSCP plans to develop a cycle path in the grounds of the new East Lothian Community Hospital. As we do this, we would like to get the views of people who walk, cycle or scoot in Haddington and the surrounding area.

The path would provide a link between the Haddington to Longniddry cycle path and Hospital Road, providing better access to both the town pathways and the A199. It would be suitable for cycling, walking and scooting.

Please help us by filling in this quick questionnaire to help us understand more about how people would use the path and what would make it a good path. https://bit.ly/3bQvWk0

The Big Night Out – Support Women’s Aid Mid and East Lothian tonight!

WAEML says:

We are delighted and thankful that a portion of the funds raised through the Comic Relief and BBC Children In Need ‘Big Night In’ this Thursday will be donated to us to help us to continue to support women, children and young people experiencing domestic abuse.

Times are tough for everyone, but for those experiencing domestic abuse, lockdown is particularly hard.

Please tune in to BBC One or iPlayer on Thursday 23rd April from 7pm to watch the Big Night In and please donate if you are able. Your support will help us keep helping those who need it.

Letter from Cabinet Secretary for Health and Social Care Jeanne Freeman about PPE

Dear Colleague,

The safety of our health and social care workforce is an absolute priority of the Scottish Government and it is vital that workers have absolute clarity on which PPE they should wear in which setting or scenario. That is why I wanted to write to you to provide you with an update of Personal Protective Equipment (PPE) availability for staff across the health and social care system.

We will be issuing almost eight million items of PPE stock in the coming week to support Primary Care and Social Care. Work continues as an absolute priority to source further PPE to ensure there continues to be an appropriate supply for all our health and social care workforce.

We monitor our supply stock, orders and delivery timelines daily and against growing demand and I can confirm we currently have adequate stock of PPE, equating to six weeks’ worth of hospital stock for the most critical items. Additional orders are continuously placed with the most recent being a further supply of FFP3 and IIR masks.

From the 30 March we introduced a number of additional steps to ensure the swift delivery of PPE to those who need it. We now have 4 delivery and distribution routes covering hospital, primary and community care, social care and the SAS. PPE supplies for pharmacy are delivered through the medicine distribution network.

We have a new dedicated email address for staff, MSPs or members of the public to raise specific supply issues. This is covid-19-health-PPE@gov.scot It will be monitored continuously and allow us to act to resolve any specific supply issues more quickly.

All of the supply and distribution of PPE follows the clinical guidance on what is required in which clinical situation or caring scenario. HPS and our Chief Nursing Officer have produced further clear information and info graphics which will be published this week and communicated directly with staff through a number of different platforms.

We are continuing to work alongside carer organisations to make sure carers have access to the right advice to help protect them are and their loved ones during this challenging period. We also know that some carers may require protective equipment should the person they are caring for be symptomatic of coronavirus. We are currently working to identify the most effective routes to direct them to the support they need.

The diagram in Annex A shows the supply routes for the four categories of health or social care provider. [See Page 4 of this attachment]

Hospital – A Single Point of Contact (SPoC) within each health board is managing coordination of PPE available on site, and ordering more as required. This system appears to be working well with decision making being quicker due to having a SPoC in place. There is a daily call with the health board contact, National Procurement and Scottish Government where issues can be raised.

Primary Care – Currently GPs contact their local Health Board SPoC to order more PPE or arrange delivery of orders. To supplement this, a new supply route is being set up to do a proactive delivery of 8 weeks’ worth of stock to each GP practice. This will be delivered to 8 hub locations, and then direct deliveries to c. 1,000 GP practices. This will begin on Monday and all deliveries will be complete by 3 April.

Social Care supply – A social care triage hub has now been operational for one week, and this is being scaled up to improve delivery to social care providers. A range of measures have been put in place from 26 March including, additional pickers to prepare orders and additional drivers in both volume and extended delivery hours.

Alongside boosting capacity within the social care triage hub, a proactive approach is being developed in parallel. This will be deliveries of PPE to local cluster points for onward distribution or collection by social care providers. This will be in place from week commencing 30 March. The supplies will be accessible to all Care Inspectorate registered social care providers, unpaid carers, personal assistants, non-registered services providing a social care support service with roles that have a need for PPE, and hospices. There will be up to 70 cluster points across the country – these are being identified and may be schools, community centres, or other appropriate locations.

The SSSC and NES have developed a core PPE training package for social care for those who are being redeployed to care roles, and for volunteers. Scottish Ambulance Service supply – Deliveries are made direct from National Procurement to two agreed locations in the central belt which a SAS SPoC manages. This process has not changed from the previous approach and has continued to strengthen as it beds in.

I would be grateful if you could share this information with your members.

Once again, I am thankful for all the hard work each and every one of you and your members are doing to support the people of Scotland in these difficult times. Let me also stress that should you have any concerns on this or any other matter, I hope you will not hesitate to contact me directly.

Kind regards,

JEANE FREEMAN

New COVID-19 Assessment Hub opens in Musselburgh

East Lothian Health and Social Care Partnership has opened COVID-19 Assessment Hub in Musselburgh as part of NHS Lothian’s regional strategy for the management of patients needing assessment for possible coronavirus infection.

Dr Alastair Clubb, East Lothian Health and Social Care Partnership’s Primary Care Clinical Lead says:

‘The team will assess people who have been advised to attend by NHS24’s Call 111 service after phone triage. I want to make it very clear this is not a drop-in facility. The team does not carry out laboratory testing for coronavirus.

‘Patients who have symptoms suggestive of COVID-19 infection should follow the guidance and advice on self-care and isolation on the NHS Inform web site (https://www.nhsinform.scot). It will take you through your symptoms and tell you if you are one of the small number of people should contact NHS24’s Call 111 service for further assessment over the phone. A very small number of patients assessed over the phone will be advised to attend one of the assessment centres in the Lothian region.

‘Following these steps ensures that patients are safely assessed and allocated to the correct service for their needs. And it reduces the risk of transmitting the virus – the most important action we can all take during the pandemic.’

Patients attending the centre in Musselburgh will be greeted by the clinical team who will already have all the relevant clinical information for patients. Most patients will be assessed without having to leave their car because the team is able to do this by going through a number of simple observations (for example, temperature, oxygen saturation, appearance, etc). It will usually not be necessary to give patients a full clinical examination, for example, a chest examination. Routinely carrying out clinical examinations could increase the risk of virus transmission.

A small number of patients attending will be brought in to the centre for further assessment and then directed towards the appropriate care, either at home or in hospital. It is worth noting that the service in Musselburgh is not a drop-in service and does not carry out testing, because most patients will not need it. In line with the national guidance, people should manage their symptoms at home, whenever possible.

Dr Clubb says:

‘The pathway for accessing the service is designed to ensure the safety of patients and staff alike. In the event of a life-threatening emergency always call 999.’

East Lothian Health and Social Care Partnership’s Chief Officer Alison Macdonald adds:

‘I would like to thank the team for getting the service up and running safely and quickly. We are well-placed to do this because we have been able to draw upon the expertise of the CWIC team, which has been developed over the last two years in our primary care service in Musselburgh.

‘I would also like to re-iterate what Dr Clubb said about sticking to the rules. It is crucial that we all adhere to the guidance on contacting NHS 24’s 111 service – by doing this, you are doing your bit to help the NHS manage during these challenging times. Thank you.’