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Social circumstances reports

 

Provision of social circumstances reports following short term detention by local authority 2009-10*

AR-09-10-Table35
 Our interest in this

Social circumstances reports (SCRs) are an important source of information for a person's responsible medical officer (RMO)  in assessing need and planning care and treatment.  SCRs identify, at an early point, wider aspects of a person's health and welfare and can help identify the support needs of carers, which may also need to be addressed as part of the development of a person's care and treatment plans.

The SCR also provides us with a source of information about the the patient's circumstances prior to their being subject to compulsory powers. They can help us to determine whether any alternative courses of action might have been, or are being considered, and what these courses of action are. 

SCRs can alert us to concerns about the person's care and treatment prior to admission, that we might wish to make further enquiries about. If mental health officers (MHOs) have concerns about an individual's circumstances, we ask them to draw these to our attention when they send us the report.

What we found

In nearly 50% of cases where a person was placed on a short term detention or a compulsory treatment order, and an SCR should have been provided, we received neither an SCR nor a notification that an SCR would serve 'little or no practical purpose' . This appears to be a high non-response rate. It may be that MHOs are either unaware of their duty or that they, or their managers, do not believe complying with this part of the legislation has priority.  We have provided  to assist mental health officers and their managers on the provision of SCRs. The granting of a short term detention certificate is a relevant event that should most often trigger an SCR.

Two years ago 39% of STDs resulted in an SCR. Last year this figure went up to 43%, but this year it fell back to 41%.

When we do not receive an SCR we are often unable to identify exactly which local authority is responsible for failing to comply with this duty. Where details are available, we can see that differences in the provision of SCRs ranges widely from one area to another. Those differences between areas are fairly consistently from one year to the next.  From Highland Region we received nothing following an STD or subsequent CTO in over 80% of cases, whereas from North Ayrshire Council we receive an SCR or a letter in 91% of cases, with an SCR being provided for 83% of all relevant events.

Both Glasgow City and Edinburgh Council failed to provide either a letter or an SCR in about 70% of STDs. In Dundee City MHOs managed to provide a letter in 25% and an SCR in 44% of cases.

What we cannot tell is in how many of the cases of non-compliance the SCR would have served little or no purpose, and in how many cases the duty to write an SCR is being ignored.

We have consistently argued that the role of the MHO within Scottish legislation is to bring and present a valuable perspective to the care and treatment of people with mental health problems and we will continue to promote the writing of SCRs as one important element of this.

We aim to follow up on the recommendations made in our good practice guidance on the preparation of SCRs published in April 2009 with a focussed report in 2011.