Fiona Dobbie, Susan Reid, Claudia Martin, Anne Birch
Scottish Centre for Social Research
ISBN 978 0 7559 7431 3 (Web only publication)
ISSN 0950 2254
This document is also available in pdf format (4.4mb)
CONTENTS
ACKNOWLEDGMENTS
EXECUTIVE SUMMARY
CHAPTER ONE INTRODUCTION
Mental Health (Scotland) Act 2003: key elements
The Mental Health Tribunal Service
CHAPTER TWO RESEARCH AIMS AND OBJECTIVES
Aims and objectives
CHAPTER THREE RESEARCH DESIGN AND METHODS
Summary of the research
Stage One - An exploration of the operation of MHTS
Stage Two - Whole System Approach to identify barriers and improvements
Stage Three - Identification of the costs of MHTS
Research access and ethics
Stage One - An exploration of the operation of MHTS
Analysis of MHTS case processing and hearings data
In-depth interviews with Tribunal key informants
Small group discussions with Tribunal panels
Analysis
Stage Two - Whole System Approach
Stage Three - Assessment of MHTS costs
CHAPTER FOUR MHTS DATA
Data Held by MHTS Administration Office
Processing CTO Applications
Data Reporting and Quality
Data analysis
CTO Applications
CTO Application Timescales
Hearing Venues and Attendees
CTO Hearings and Outcomes
Key findings
CHAPTER FIVE THE EARLY OPERATION OF THE MHTS
Roles within MHTS
Mental Health Officers
Advocacy Workers
Solicitors
Responsible Medical Officers
National bodies
Frequency of hearings
Level of pay and conditions
CTO applications
Writing the application
Submission of CTO application
Problems with the CTO application form
Hearings
Named persons
Short notice
Hearing preparation
Hearing duration
Perceptions of patients' experiences
Patients' needs and venues
Recommendations for improvements to hearings
Interim Compulsory Treatment Orders
Factors associated with perceived increased use of iCTOs
Convoluted Curator Ad Litem process
Independent Medical Reports
Other reasons for iCTOs
Informants Suggestions to reduce iCTOs
Efficiency and efficacy of MHTS
Improving MHTS
Key points
CHAPTER SIX MHTS COSTS
MHTS Administration total costs for 2006-2007
Legal costs for 2006-2007
Individual component costs
Health Board and Local Authority costs
Overall cost of the MHTS process 2006-2007
Costs per hearing
Key points
CHAPTER SEVEN CONCLUSIONS & RECOMENDATIONS
GLOSSARY OF TERMS
REFERENCES
LIST OF APPENDICES
Appendix A - List of data requested from MHTSA
Appendix B - Stakeholder topic guide case study areas
Appendix C - Stakeholder topic guide national perspective
Appendix D - Topic guide for mini focus groups
Appendix E - Research Information Leaflet
Appendix F - Thematic Chart Example
Appendix G - System Mapping Workshop Information Leaflet
Appendix H - Consent Form
Appendix I - System Mapping Workshop - report to participants
Background and Purpose
Preparation and overview of the day
Session 1 - The improvements achieved by the new Tribunal system
Session 2 - System mapping - exploring the experiences of people with the Tribunal system
Session 3 - How the Tribunal system might be improved
In-house screening convenor/Tribunal
Dealing with the consequences of the legal / evidential nature of the tribunals
Administration
Training
Initiatives focused on particular roles
The need for a spokesperson to address the media
Prevention - increasing rates of non-compulsory care
Reflections - What I might do differently
Conclusion
Participant list
System map
LIST OF TABLES
Table 3.1 Key informant interviews by area and interview mode
Table 4.1 Age of CTO Applicants
Table 4.2 Age of CTO Applicants by local authority Case Study Areas
Table 4.3 CTO Applications per Patient
Table 4.4 Days from Application Received to 1st Hearing
Table 4.5 Hearings Venues
Table 4.6 Hearing Attendees by Type
Table 4.7 Hearings by local authority
Table 4.8 Number of Hearings per patient
Table 4.9 CTOs and Interim CTOs Granted by Quarter
Table 4.10 Number of Hearings per Case
Table 4.11 Community and Hospital CTOs by Local Authority
Table 6.1 Tribunal costs for 2006-2007
Table 6.2 Administration costs for 2006-2007
Table 6.3 Mental health cases requiring Legal Aid 2006-07
Table 6.4 Individual component costs that solicitors can claim from SLAB
Table 6.5 MHTSA projected hearing costs for 2008-2009
LIST OF FIGURES
Figure 4.1 CTO Applications by Month
Figure 4.2 CTO Applications by local authority
Figure 4.3 Application Rates per 100,000 Population
Figure 4.4 Hearing Outcomes
Figure 4.5 Hearing Outcomes by Local Authority
The views expressed in this report are those of the researcher and
do not necessarily represent those of the Department or Scottish Ministers.