Consultant Psychiatrists' Knowledge of Mental Health Legislation in Scotland

Abstract

There has been increasing concern recently over an apparent lack of knowledge of mental health law among psychiatrists and other medical practitioners involved in its use. This has been particularly highlighted by the introduction of new and complex legislation intended to facilitate care in the community. As a result of findings from previous studies of other groups of medical practitioners in Scotland, a national survey of consultant psychiatrists working there was undertaken to determine their level of understanding of the statutory provision for the care of the mentally disordered. A purpose-designed instrument was used at interview with 72 consultants chosen at random from all psychiatric specialties. Their knowledge of even the most basic definitions and fundamental areas was limited, with only just over half being able to give the correct title of one relevant piece of legislation and only one in 10 being able to define mental disorder in terms of the Act. Otherwise knowledge was generally patchy. Greater emphasis should be placed upon training in mental health law for consultant psychiatrists in general, as the findings are unlikely to reflect purely localized patterns. Attitudes to the use of compulsory measures also need to be addressed.

Models of advance directives in mental health care:

“…Research suggests that mental health professionals' knowledge of the law may not always be clear [28,29]. This was reflected in not all respondents understanding that patients in the UK can currently make advance directives under common law in respect to treatment, al- [27].Those who saw Model I as destigmatising because it conveyed the same rights on psychiatric patients as medical/surgical patients may have been misled.…”

(In) capacity legislation in practice

“…(Wilks, 2004) Consultant psychiatrists in Scotland appear to endorse these sentiments and demonstrated good knowledge of the AWIA. Their familiarity with this legislation compares favourably with their knowledge of the Human Rights Act 1998 (Passmore & Leung, 2003) and mental health law (Humphreys, 1998).…”

Consultant psychiatrists' knowledge of their role as representatives of the responsible authority at mental health review tribunals

“…Although psychiatrists are skilled and experienced at presenting psychiatric opinions, they may be less well prepared for the duties required of them as representatives. Consultants' knowledge of mental health law has generally been shown to be poor, although some studies show better levels of knowledge (Humphreys, 1999;Bhatti et al, 1999;Peay et al, 2001).…”