Abstract Book - International Academy of Law and Mental Health

The Mental Health (Care and Treatment) (Scotland) Act (2003), introduced in October 2005,brought a fundamental change to the criterion for compulsory treatment. For the first time inUnited Kingdom mental health legislation, a capacity criterion was introduced for short-term andcompulsory treatment orders. This criterion states: “that because of the mental disorder thepatient’s ability to make decisions about the provision of medical treatment is significantlyimpaired.” Significantly impaired decision-making ability (SIDMA) is not the same as“incapacity” under the Adults with Incapacity (Scotland) Act 2000 but is a “related concept”based on similar factors, but with a lower threshold. As such, the law in Scotland “recognisesthat patients with mental disorder may have impaired capacity which, while damaging theirability to make decisions, does not render them entirely incapable.” This was seen as being amore ethical and less discriminatory way of dealing with people with mental disorders. There isno precise threshold for SIDMA, which means that there can be different interpretations withinand between different professional groups, depending on the circumstances and complexity ofany given assessment. It is important to understand how different groups view this possibilityand what provisions they expect to make. This presentation focuses on the findings of a studywhich assessed relevant professional groups (psychiatrists, mental health officers) views abouthow SIDMA is being applied by professionals, including potential differences between groups,the impact of the inclusion of the criterion on decisions about compulsory treatment and thesetting for treatment.The Impact of Significantly Impaired Decision-Making on HighReadmission Rates to Hospital: A Psychological PerspectiveNicola Cogan, NHS Lanarkshire, South Lanarkshire, UK (nicola.cogan@lanarkshire.scot.nhs.uk)Polash Shajahan, NHS Lanarkshire, South Lanarkshire, UK(polash.shajahan@lanarkshire.scot.nhs.uk)Julie Langan, NHS Lanarkshire, South Lanarkshire, UK (julielangan1@hotmail.com)Psychiatric hospitalization is a major life event for both patients and families and has significantsocietal costs. Readmission rates have been used to monitor success in preventing, or reducing,unplanned readmissions to hospital for acute psychiatric services. Repeated emergencyadmissions to acute in-patient psychiatric units have been variously defined and such individualshave been known as “high readmission” patients. In 2008, the Scottish Government set NHSHealth Boards specific Health Efficiency Access and Treatment (HEAT) targets. Target 3 was to“reduce the number of readmissions (within one year) for those that have had a hospitaladmission of over seven days by 10%.” The Scottish Patients at Risk of Readmission andAdmission (SPARRA) is a risk prediction algorithm, developed by the Information ServicesDivision (ISD) Scotland. It aims to identify patients at greatest risk of emergency admission. TheSPARRA for mental disorders has been considered potentially useful in planning healthcareprovision and measuring the effects of service redesign. This presentation will outline data on theclinical and demographical characteristics of “high readmission” patients within a NHSLanarkshire locality. It will draw upon empirical findings on how “high readmission” patientswere significantly more likely to have Compulsory Treatment Orders under the Mental Health46