Approved Medical Practitioners - Mental Health (Care and Treatment) (Scotland) Act, 2003 Training Manual

Section 8. Responsibilities of Statutory Bodies in Administering the 2003 Act

A number of statutory bodies have defined responsibilities under the 2003 Act. These include:

• The Mental Welfare Commission which is set up by parliament to exercise protective functions in Scotland for people with a mental disorder. This is principally done via the 2003 Act, and the Adults with Incapacity (Scotland) Act 2000. For example, the Commission can revoke a short-term detention certificate, extension certificate, interim CTO, CTO or compulsion order. The Mental Welfare Commission also has responsibility to promote best practice and monitor and report on use of the 2003 Act.

• NHS Boards which are required to maintain and update lists of AMPs. Section 230 states that hospital managers must appoint an AMP to act as a patient's responsible medical officer 'as soon as is reasonable and practicable'. Managers of medical/surgical hospitals will therefore need to have arrangements to provide AMPs in place, and medical/surgical consultants should not discharge a detained patient without prior revocation of detention by the appointed AMP.

NHS Boards have a responsibility to provide adequate services for mentally disordered children (those under 18 years), and a duty to provide services to allow mothers in hospital with post-natal depression or other peri-natal mental disorder to be placed with their children under one year old, where clinically appropriate.

• Local authorities have a duty to promote the well-being and social development of people with mental disorder outwith hospital, and facilitate socio-cultural and recreational activities for those in hospital. This would include help with travel to facilities.

Local authorities have a duty to appoint a sufficient number of MHOs, and ensure that one is allocated to each detained patient.

The Code of Practice to the 2003 Act recommends that localities develop appropriate 'Psychiatric Emergency Plans' ( PEPs) in consultation with the multidisciplinary team, local agencies (such as police and ambulance services and MHOs) and user and carer groups. These PEPs would detail the process for detention and transfer of patients in a safe, calm and dignified manner.

Local authorities' duty to inquire deals with orders to gain access to remove individuals who are thought to have a mental disorder, including:

• Local authorities' duty under Section 33 to inquire into the situation of a mentally disordered person over 16 years of age who may be vulnerable to neglect or ill-treatment.
• The MHO can apply to a sheriff for Section 35 warrants, which confer powers of access and detention for assessment and allows access to medical records, but not the removal of the person.
• The MHO can apply to a sheriff for power to grant a removal order under Section 293 to remove a mentally disordered person to a place of safety and detain him or her there for up to 72 hours.
• Power invested in an authorised (Section 292) individual to remove a mentally disordered person to a place of safety, including allowing police to open locks.
• Power given to police (under Section 297) to remove a mentally disordered person from a public place to a place of safety.

Approved medical practitioners are not directly involved in these sections.

• Independent advocacy services. Local authorities, NHS Boards and the State Hospital have a duty to secure independent advocacy services for people with mental disorder. Advocacy is support and representation enabling influence over care and welfare.

Advocates do not determine what a person's 'best interests' may be. They should be permitted to:

• Attend meetings or consultations regarding treatment.
• Receive appropriate correspondence and other information.
• Have reasonable access to their client.

Independent advocates should be independent to the patient, meaning they should not be care providers.