Mental Health (care and treatment) (Scotland) Act 2003: Code of Practice Volume 1

Chapter 17: Glossary of Commonly Used Terms

Advance statement: this is a document drawn up in accordance with sections 275-6 of the Act. It is a written and witnessed document which is made when the patient is well and which sets out how he/she would prefer to be treated (or not treated) if he/she were to become ill in the future. The Tribunal and any medical practitioner treating the patient must have regard to the advance statement. A medical practitioner must also send to the Commission a written record of the reasons why the wishes set out in the advance statement have not been followed.

Assessment Order (section 52 of the 1995 Act): an order imposed by a criminal court prior to trial and/or after conviction before sentencing which authorises hospital detention for up to 28 days so that the patient's mental condition may be assessed. Medical treatment under Part 16 of the Act may be given to a patient in certain circumstances while subject to this order. It may be extended once only for a period of 7 days.

Approved medical practitioner: this is a medical practitioner who has been approved under section 22 of the Act by a Health Board or by the State Hospitals Board for Scotland as having special experience in the diagnosis and treatment of mental disorder. An approved medical practitioner will often be a consultant psychiatrist. Only an approved medical practitioner can grant a short-term detention certificate; and at least one of the two mental health reports forming part of a compulsory treatment order application must be provided by an approved medical practitioner.

Authorised person's warrant/a "section 292 warrant": this warrant authorises a person to enter the premises of another person where the person entering the premises has already been given the authority under another provision of this Act to take the person to another place or into custody. This could happen, for example, in a situation where a patient has absconded and a person who has been authorised under section 303 of the Act to take that patient into custody or to return them to hospital requires entry to the premises where the patient has been found.

Care plan: this is a document prepared by the patient's responsible medical officer under section 76 of the Act after a compulsory treatment order has been made. It lays out the forms of medical treatment and the other services the patient will be receiving while subject to the compulsory treatment order. This document should not be confused with the "proposed care plan" which is prepared under section 62 of the Act as part of the application for a compulsory treatment order.

Compulsion Order (section 57A of the 1995 Act): a final disposal imposed by a criminal court which authorises hospital detention or compulsory powers in the community for a period of 6 months, if not otherwise renewed. It may be renewed for 6 months and then annually thereafter. The procedures for the review of this order and for its renewal, variation and revocation are almost identical to those for a compulsory treatment order imposed under civil proceedings.

Compulsory treatment order: this is an order granted by the Tribunal under section 64(4) of the Act. It authorises any of the compulsory measures listed at section 66(1) for a period of 6 months, if not otherwise renewed. The compulsory treatment order can be renewed for 6 months, then for 12 months thereafter.

Designated medical practitioner: this is a medical practitioner appointed by the Mental Welfare Commission under section 233 of the Act. The function of a designated medical practitioner is to provide a second medical opinion with respect to certain medical treatments being given under Part 16 of the Act.

Emergency detention certificate: this is a certificate granted under section 36 of the Act. Where strict criteria have been met, it authorises the removal of a person to hospital within 72 hours and the detention of that person in hospital for a further 72 hours. An emergency detention certificate can be granted by any fully registered medical practitioner who has, where practicable, consulted and sought the consent of an MHO to the granting of the certificate.

Extension certificate: this is a certificate issued under section 47(1) of the Act. Where strict criteria have been met, it extends a period of short-term detention by 3 working days (not 3 calendar days) to allow for the preparation of an application for a compulsory treatment order.

Hospital Direction (section 59A of the 1995 Act): a final disposal imposed by a criminal court in addition to a sentence of imprisonment which allows the person to be detained in hospital initially for treatment for mental disorder and then transferred to prison to complete their sentence once detention is hospital is no longer required.

Independent Advocate: a person who enables the patient to express their views about the decisions being made about their care and treatment by being a voice for the patient and encouraging them to speak out for themselves. An independent advocate is employed by an advocacy organisation which is not directly funded or run by the Health Board or local authority. All people with mental disorder have a right to independent advocacy, not only those subject to compulsory measures.

Interim Compulsion Order: an order imposed by a criminal court after conviction and before sentencing which authorises hospital detention for assessment and treatment for a period of 12 weeks to allow further evidence to be obtained with respect to the person's mental disorder and the risk that they pose as a result of this disorder. It may be renewed regularly for up to 1 year.

Interim compulsory treatment order: this is an order granted by the Tribunal under section 65(2) of the Act. It authorises any of the compulsory measures listed at section 66(1) of the Act for a period of up to 28 days at a time. An unlimited number of interim orders can be granted as long as the total detention period authorised by the interim orders does not exceed 56 consecutive days.

Mental health officer's report: this is a report prepared under section 61 of the Act. It is prepared by the mental health officer as part of the application for a compulsory treatment order. It must detail background information on the person who is the subject of the application.

Mental health report: this is a report required under section 57(4) of the Act and prepared by a medical practitioner. Two such reports must form part of the application for a compulsory treatment order. The practitioner must lay out in this report the reasons why he/she believes that a compulsory treatment order is appropriate.

Multi-disciplinary team: this is the team providing care, treatment and support to the patient while they are in receipt of mental health services. The membership and nature of the team will necessarily vary according to the needs and circumstances of the patient. It would, however, be expected that the team would be made up of, where appropriate and relevant, medical practitioner(s), an MHO and other social workers, nursing staff/Community Psychiatric Nurses, psychologists, occupational therapists etc. The team may also include community care service providers or voluntary organisations providing care and treatment. These components of the multi-disciplinary team would work together to co-ordinate and agree on all aspects of the patient's care and treatment. Multi-disciplinary working of a high quality will necessarily entail a genuine respect for the opinions of all members of the team; regular communication between all members of the team; and clearly defined information sharing processes.

Named person: this is someone nominated by a person in accordance with the provisions of Part 17 Chapter 1 of the Act to support them and protect their interests. The named person is entitled to receive certain information about the person and to act on behalf of the person in certain circumstances and at certain times set out in the Act.

Nearest relative: there are occasions in the Act where the nearest relative is given information about a person coming under the provisions of the Act, such as where a person is removed to a place of safety. Section 254 of the Act sets out a list of the people who will be considered in identifying a person's nearest relative.

Nurse's holding power: this is a power which can be exercised by nurses of a prescribed class by way of section 299 of the Act to hold a patient for up to 2 hours while awaiting a medical examination.

Place of safety: Section 300 defines a place of safety as a hospital, premises which are used to provide a care home services or any other suitable place (other than a police station) where the occupier is willing to temporarily receive a person with mental disorder. However, if no place of safety is available, a police officer may remove a person to a police station which should then be treated as a place of safety for the purposes of the person's detention.

Part 9 care plan: this is a document prepared by the patient's RMO under section 137 of the Act after a compulsion order has been imposed by a criminal court. It contains the same core information as the care plan of a patient who is subject to a CTO in that it sets out the forms of care and treatment for the mental disorder that the patient will receive while subject to the order but it also includes other information to take account of the status of the patient as a mentally disordered offender.

Proposed care plan: this is a document drawn up under section 62 of the Act by the MHO who is making the application for a compulsory treatment order. It contains details of the medical treatment for mental disorder, the community care services; and any other forms of care and treatment which it is proposed to provide to the patient if the compulsory treatment order is made. The "proposed care plan" should not be confused with the "care plan" which is prepared under section 76 of the Act by the patient's RMO subsequent to the making of a compulsory treatment order.

Removal order/"a section 293 warrant": an order granted by a sheriff or a justice of the peace under section 293(1) of the Act. It authorises certain persons to enter the premises of an individual at risk in order to remove them to a place of safety. It also authorises a constable to open lock-fast places and the detention of the person for 7 days.

Restriction Order (section 59 of the 1995 Act): an order imposed by a criminal court in conjunction with a compulsion order with the result that the measures specified in the compulsion order are without limit of time.

Section 35 warrants: these are warrants issued by a sheriff or a justice of the peace on an application from an MHO. The purposes for which these warrants can be granted are to enter premises; to detain a person in order to carry out a medical examination; and to allow a medical practitioner access to a person's medical records. There is no right of appeal against a warrant being granted or not being granted under section 35.

Section 68 detention period: this is a period of detention which lasts for 5 working days (not 5 calendar days). This detention period occurs automatically once an application for a compulsory treatment order has been submitted to the Tribunal. It begins on the expiry of a short-term detention certificate or an extension certificate, depending on which certificate the patient is subject to. The Tribunal must determine the compulsory treatment order application by the end of this section 68 detention period.

Section 86 determination: this is a determination made by the patient's RMO under section 86 of the Act to extend the compulsory treatment order without any variation of the compulsory measures or recorded matters specified in the order. A compulsory treatment order can be extended for 6 months, then for 12 months at a time thereafter. However, the Tribunal must review an order if it has not done so at any point within the previous 2 years. The Tribunal must also review section 86 determination if the MHO disagrees with this determination or if there is a difference between the type(s) of mental disorder stated in the section 86 determination and those in the compulsory treatment order.

Section 92 application: this is an application which the patient's RMO must make to the Tribunal under section 92 of the Act where he/she wishes to extend a compulsory treatment order with a variation of the compulsory measures or recorded matters specified in a compulsory treatment order.

Section 95 application: this is an application which the patient's RMO must make to the Tribunal under section 95 of the Act where he/she wishes to vary the compulsory measures or recorded matters specified in a compulsory treatment order.

Section 292 warrant: see " authorised person's warrant".

Section 293 warrant: see " removal order".

Short-term detention certificate: this is a certificate issued under section 44(1) of the Act. Subject to strict criteria, it authorises the conveyance of a person to hospital within 3 days of the certificate being granted, and then the detention in hospital of that person for a period of up to 28 days. A short-term detention certificate can only be granted by an approved medical practitioner with the consent of an MHO.

Social circumstances report ( SCR): this is a report prepared by an MHO under section 231 of the Act. It must be produced within 21 days of any of the following events taking place: the granting of a short-term detention certificate; the making of an interim compulsory treatment order; a compulsory treatment order; an assessment order; a treatment order; an interim compulsion order; a compulsion order; a hospital direction; or a transfer for treatment direction. However, an MHO does not need to complete an SCR where he/she is satisfied that an SCR would serve little or no practical purpose. However, a record must be produced stating why the SCR is not being prepared. This record must be sent to the Mental Welfare Commission and to the patient's RMO.

Suspension certificate: this is a certificate granted under section 41, 53, 127 or 128 of the Act. A suspension certificate granted under sections 41, 53 or 127 suspends the hospital detention requirement of an emergency detention certificate, a short-term detention certificate or a CTO respectively. A suspension certificate granted under section 128 can suspend any measure authorised in a CTO other than the hospital detention requirement. Under the Mental Health (Scotland) Act 1984, "suspension" was sometimes referred to as "leave of absence" or "being out on pass".

A suspension certificate may also be granted with respect to a patient who is subject to criminal justice proceedings. The processes involved in granting and revoking such a certificate are set out in Part 13 of the Act with the exception of a certificate with respect to a patient who is subject to a compulsion order without a restriction order; these are set out in section 127 as applied by section 179(1). Similar to CTOs, a suspension certificate granted under section 128 as applied by section 179(2) may suspend any measure in a compulsion order other than the hospital detention requirement.

Transfer for Treatment Direction: an order made by the Scottish Ministers under section 136 of the Act which allows the transfer of a prisoner to hospital for treatment of a mental disorder.

Treatment Order (section 52M of the 1995 Act): an order imposed by a criminal court which authorises hospital detention for treatment for mental disorder. Section 52R of the 1995 Act sets out the circumstances in which this order ceases to have effect.