Overrides of advance statements
Our interest in these figures
Before the Mental Health (Care & Treatment) (Scotland) Act 2003 was introduced we consulted with stakeholders to identify those areas they felt we should monitor. Many people who had experience of using mental health services told us they were concerned that 2003 Act's provision for service users to influence their care and treatment through written advance statements, would be limited by practitioners overriding their expressed views.
In response to this concern, we committed to monitoring overrides of advance statements as part of our work to monitor the principle of participation which underpins the 2003 Act. It is difficult for us to know what proportion of advance statements are overridden as we currently have no way of knowing how many have been prepared.
What we found
We continue to receive a small number of notifications in respect of advance statement overrides. We follow up all notifications to determine the nature of the override. Not all are genuine overrides. In some cases the advance statement does not comply with the requirements of the 2003 Act. In others, the person agrees with the proposed treatment, despite what is set out in the advance statement.
We have not included those overrides where the only statement is the refusal of admission to hospital.
We have also become aware of a number of circumstances where patients are being encouraged to complete advance statements immediately prior to Mental Health Tribunal hearings. We do not think that this complies with the requirements of the 2003 Act.
Advance statements should be completed before treatment starts, at a time when the individual's capacity in respect of treatment for mental disorder is not significantly impaired. We think everyone involved should make sure that their practice does not encourage people to prepare advance statements when they aren't able to think clearly about what might be in their best interests. We do remind everyone of the importance of taking account of the person's present wishes when providing care and treatment.
Annual reports
- directors introduction
- overview of the Mental Health (Care & Treatment) (Scotland) Act 2003 introduction
- new orders granted in 2008-09
- total numbers of 2003 Act orders in existence
- monitoring our priority areas
- monitoring of priority areas
overrides of advance statements
- community based compulsory treatment
- services for young people
- additional findings from our monitoring of mental health law
- our overview of the use of the Adults with Incapacity (Scotland) Act 2000