Setting

This audit is suitable for all areas of psychiatry where patients are detained under the Mental Health (Care and Treatment) (Scotland) Act 2003. In the original audit, a general adult psychiatry ward was the setting. It would also be possible to convert the methodology to other jurisdictions that use similar mental health legislation.

Background

The Mental Health (Care and Treatment) (Scotland) Act 2003 came into force in October 2005. It suggests that the short-term detention order is used as a ‘gateway order’. It specifies a number of principles that must be considered by any person utilising the provisions of the Act. One of these is that patients should participate in all aspects of their care, treatment and support. Patients are also given the option of preparing an advanced statement, which has to be considered when delivering their care.

Standards

Standards are taken directly from the Mental Health (Care and Treatment) (Scotland) Act 2003. Of particular relevance were the following:

ᐅ In at least two-thirds of admissions involving the Mental Health Act, a shortterm detention certificate should be used.

ᐅ All patients should have any subsequent detentions made within the specified period.

ᐅ All section papers should be present in the case notes.

ᐅ All patients should have copies of the relevant detention and letters informing them about their detention and rights.

ᐅ All named persons should receive copies.

ᐅ All documentation of suspension or revocation should be recorded in the

case notes.

Method

Data collection

Initially, the population under study was defined. In the original audit, the population included all patients detained in one general adult ward and corresponding community mental health teams (CMHTs) over 1 year. A list of detained patients was kept by the local medical records department. The medical notes were inspected to find the following:

ᐅ the type of detention certificate used at the time of admission

ᐅ the timing of subsequent detentions

ᐅ copies of relevant section papers

ᐅ copies of letters informing the patient of his or her rights

ᐅ evidence of the named person having been informed and evidence of appropriate copies having been sent to him or her

ᐅ documentation on the suspension or revocation of detention (if relevant).