NSF(Scotland) is a national charity providing support and direct services. Through the often hard personal experiences of our members we are well placed to comment on a number of issues being considered by the current session of Parliament which have a direct impact on the well-being and quality of life of those with severe mental illness and their carers. We would like to bring these to your attention in this briefing note. As a member of the Scottish Parliament we are asking you to: understand the real wishes of those with mental illness and their carers to have a mental health law which which gives them rights and protection support the recommentations from the Accounts Commission on developing adult mental health services support the Adults with Incapacity Bill To support our submission to the Millan Committee, we conducted a survey of carers and users in Scotland. While some of the answers given were unsurprising, some clear though less 'obvious' messages emerged. As the discussion of the Mental Health Act continues, we would ask you to consider the following findings: there should be a right to a second opinion on diagnosis. Many people have experienced a change in diagnosis (for example, between schizophrenia and personality disorder) and this has an impact on the services offered. the need to detain should be seen as a last resort. Questions should also be asked afterwards as to how the detention could have been prevented 60% of service users agreed that it should be possible to detain people under mental health legislation because of a risk to the public. there was strong support for carers/relatives to have stronger rights in mental health legislation. Our survey also highlighted deficiencies in mental health care in Scotland. Fuller reports of the survey are available from our office or we would be glad to give you a more detailed briefing. Developing mental health services The Accounts Commission's recent report "A Shared Approach" has many recommendations to assist in developing adult mental health services in the areas of health and social services and in community care. We would particularly draw to your attention the following: staff resources The workloads of staff working with severely mentally ill people must be managed so that they can supply the level of support that is required for individual needs. NSF(Scotland) has serious concerns for the maintenance of quality services with existing staff resources. involving servicer users and carers We are members of the voluntary sector consortium which has established Allies in Change. This project will increase the ability of service users and carers to be involved and to assist in developing good mental health services. We look to parliament to support the development of this involvement including evaluation of services. good practice CRAG guidelines, guidance from the Mental Health Reference Group, other professional bodies and the developing clinical standards must be adopted as widely as possible to remove deficiencies in care. comprehensive services Services need to be strategically planned and delivered across Scotland rather than being patchy and inconsistent as at present. This will require an improvement in joint working between agencies. We support this legislation. In particular we know that there are people who, when they are well, are capable of making sensible decisions about the treatment that they will or will not want to undergo when they are ill. Their views must be taken into account when there is no over-riding risk to the patient or others. There will be a number of issues where we will seek to improve the regulations associated with this legislation. There is however one area which is causing some concern. That is the requirement for insurance protection to be taken out by those responsible for financial affairs. While understanding the reason for this, it may cause severe problems for carers. The parliament or individual members could help in persuading insurance companies to offer this insurance at a reasonable, affordable level for the financial guardian and the adult with incapacity. People who use our drop-in centres and our staff would be glad to meet you and tell you about our experiences. We can put you in touch with our projects round the country where you can meet the real experts - those with direct experience of the illness and their carers. The National Schizophrenia Fellowship (SCOTLAND) is a member led organisation which works to improve the wellbeing and quality of life of those affected by schizophrenia and other mental illnesses, including families and carers. We represent the interests of our 500+ members, and our service users, and promote meaningful involvement and empowerment of service users and carers in all support and services. NSF (SCOTLAND) provides community based services to carers and service users, provides information/education and promotes greater public understanding of schizophrenia Contacts: For general information: Ian Harper, Information Officer To meet some of our service users: Paddy Carstairs, Operations Manager Re the review of the Mental Health Act: Mary Weir, Chief Executive Address: NSF(SCOTLAND) Claremont House 130 East Claremont Street Edinburgh EH7 4LB Email: [email protected] Web site: www.nsfscot.org.uk Phone no: 0131 557 8969 Fax: 0131 557 8968