Learning disability and the Scottish Mental Health Act
| DOI | https://doi.org/10.1108/AMHID-11-2016-0038 |
| Published date | 06 March 2017 |
| Pages | 74-82 |
| Date | 06 March 2017 |
| Author | Heather Welsh,Gary Morrison |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Learning disability and the Scottish
Mental Health Act
Heather Welsh and Gary Morrison
Abstract
Purpose –The purpose of this paper i s to investigate the use of th e Mental Health (Care and
Treatment) (Scotland) Act 2003 for people with learning disabilities in Scotland, in the context of
the recent commitment by the Scottish Government to review the place of learning disability (LD)
within the Act.
Design/methodology/approach –All current compulsory trea tment orders (CTO) including LD as a type
of mental disorder were identified and reviewed. Data was collected on duration and type of detention
(hospital or community b ased) for all orders. For those with additional m ental illness and/or per sonality
disorder, diagnoses were re corded. For those with LD only, sym ptoms, severity of LD and treatme nt
were recorded.
Findings –In total, 11 per cent of CTOs included LD as a type of mental disorder. The majority of these also
included mental illness. The duration of detention for people with LD only was almost double that for those
without LD. A variety of mental illness diagnoses were represented, psychotic disorders being the most
common (54 per cent). Treatment was broad and multidisciplinary. In all, 87 per cent of people with LD only
were prescribed psychotropic medication authorised by CTO.
Originality/value –There has been limited research on the use of mental health legislation for people with
learning disabilities. This project aids understanding of current practice and will be of interest to readers both
in Scotland and further afield. It will inform the review of LD as a type of mental disorder under Scottish mental
health law, including consideration of the need for specific legislation.
Keywords Scotland, Intellectual disability, Learning disability, Scottish legislation, Mental Health Act,
Mental health legislation
Paper type Research paper
Introduction
Background
The definition of mental disorder in mental health law in Scotland includes three categories:
Treatment) (Scotland) Act 2003 (asp 13) (2003a) s.328).
The Mental Health (Care and Treatment) (Scotland) Act 2003 (asp 13) (2003) provides the
legislative framework for people in Scotland who have a mental disorder and have significantly
impaired decision-making ability about treatment. Compulsory powers may be utilised under the
Act in the formof an emergency detention certificate,short term detentioncertificate or compulsory
treatment order (CTO). CTOs are the focus of this project, as they authorise treatment for the
longest durationand include the greatest clinicaldetail. CTOs can be hospital or communitybased
and each order can last for up to six months. They require the agreement of the Mental Health
Tribunal, where information is presented to an independent panel of three members
(legal convenor, psychiatrist and general member) (Mental Health Tribunal for Scotland, n.d.).
CTOs can authorise medical treatment for mental disorder or causative/consequent physical
disorder. Treatment is defined broadly and can include: nursing, care, psychological treatment,
habilitation, rehabilitation, medication, physical intervention (e.g. electroconvulsive therapy)
Received 27 November 2016
Revised 25 January 2017
Accepted 6 April 2017
Heather Welsh is an ST6
Learning Disability Psychiatry
Trainee at the Kirklands
Hospital, Bothwell, UK.
Gary Morrison is the Medical
Executive Director at the Mental
Welfare Commission for
Scotland, Edinburgh, UK.
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VOL. 11 NO. 2 2017, pp.74-82, © Emerald Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-11-2016-0038
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