Sunday, 9 February 2014

"World looks to Scotland after mental health care improved" - are you serious?

Friday 7 February 2014 article in the Herald: World looks to Scotland after mental health care improved

It features retiring Chief Executive of Scotland's Mental Welfare Commission Dr Donny Lyons who says in the piece:

"Dr Lyons believes that as a consequence of these changes being implemented Scotland now leads the world in many respects in terms of its mental health system. "I think mental health care has come on a long way in Scotland over the past decade," he said. "There has been a shift in the culture of doing things to people with mental health issues to doing things with people."
"Over the past 14 years a raft of new laws - including the Adults With Incapacity (Scotland) Act 2000, the Mental Health Act (Care and Treatment) (Scotland) 2003 and the Adult Support and Protection (Scotland) Act 2007 - ushered in vast changes, giving more rights to patients, setting out more protections from ill-treatment and giving them more of a voice. Part of Dr Lyons's job has involved monitoring this new legislation in practice."

On reading this I made an immediate response in a comment which was published:

"As a mother, carer and survivor of mental illness and psychiatric treatment, living in Fife, I have to disagree with Dr Lyons regarding the efficacy of Scotland's Mental Health Act for people with a "mental disorder" and their carers. It has been my experience over the last 5 years and more that the Act isn't implemented appropriately and the safeguards within the Act aren't safe. The principle of "Respect for Carers" hasn't been practised where I live and the rights of the family member I care for were not protected under the Act.

Because of the human rights issues I have experienced and the lack of respect I now find myself a writer, activist and campaigner in mental health matters, and participate in many national mental health groups from the carer and survivor perspective. I speak out from personal experience and from the stories told to me my others, of the difficulties faced in psychiatric settings when someone is deemed to be "without capacity" and drug treatment is forced upon them, under the Act. 

Unfortunately the mental health law in Scotland has been used by professionals to justify coercive treatment and leaving carers out of the loop. Confidentiality is used to keep information from family members and the named person role in the Act, if it is the carer, can be disregarded or not given its full place. I want to see safer psychiatric settings for detained patients under the Mental Health Act where the patient and their carer is listened to and respected, even when disagreeing with treatment. Having a "mental illness" should not mean disregarding a person's wishes or overriding their concerns.

I only want what other hospital patients receive which is person-centred care and treatment in a safe environment with family members and carers respected and informed at every stage of the patient journey into discharge."

I've engaged with the psychiatric system in Scotland since 1970 and unlike Dr Lyons I haven't seen major improvements in the care of patients.  In fact where I live in Fife things have got steadily worse since 1995 when I first had a family member an inpatient in Stratheden Hospital.

In my experience the mental health act hasn't made it safer for my family members in psychiatric settings.  The Mental Welfare Commission and other safeguards within the Act, including Mental Health Officers, named person and the Mental Health Tribunal, have not protected the rights of my family when detained under the Act.

If it's not working for me and mine then it isn't working, in my opinion.  We can't be selective in gathering evidence or proof of efficacy.  It's not just about listening to patients and carers who have had good experiences.  And it's not just about buildings being unfit for purpose.  

It is also about staff being unfit to practise.  Mental health acts not being implemented or monitored.  Safeguards that are not safe.  Until such time that it does what is says on the tin then I contend there is nothing to be proud of.


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