Legal Issues and Carers' Rights

The areas of legislation which will mostly affect you as a carer of a person experiencing schizophrenia include:
  • The Mental Health (Scotland) Act 1984
  • The NHS and Community Care Act 1990
  • The Carers' (Recognition and Services) Act 1995

Crisis

If your friend or relative has a crisis, the first person to turn to is generally your friend or relative's GP. You could also contact your local Social Work Department and ask to speak to a Mental Health Officer (MHO) or the Emergency Duty Team out of office hours.

One course of action may be that the person should go to hospital. You can take your friend or relative yourself, but if he or she does not want to go to hospital, he or she can be detained or 'sectioned' under the Mental Health (Scotland) Act 1984 and taken to a psychiatric hospital against his or her will.

Detention

Most people who are in a mental health crisis agree to go to hospital voluntarily. However, if a person refuses to go, there are three main ways in which they can be detained under the Mental Health (Scotland) Act 1984. These are:
  • 72 hour emergency detention, usually signed by a GP and known as a 'section 24'.
  • 28 day detention in hospital which can follow emergency detention. A psychiatrist at the hospital signs the form and it is known as a 'section 26'.
  • Detention for up to six months. Two doctors need to agree to this, there is a court hearing and the matter is decided by the sheriff. This is known as a 'section 18'.
If your friend or relative is detained in hospital, and you want further advice on legal issues, contact one of the organisations listed in FACT SHEET 6.

Nearest Relative

If the person you care about has to go into hospital as a detained patient, then you may also have rights under the Mental Health (Scotland) Act 1984. The nearest relative has special rights under the Act. If you are on the list below and care for the person, then you are the nearest relative.

If not you must work your way through the list and the nearest relative will be the first that applies. The term 'patient' is used in this section instead of service user as this is the term used in the legislation.

  1. Spouse/partner
  2. Child
  3. Mother or father
  4. Brother or sister
  5. Grandparent
  6. Grandchild
  7. Uncle or aunt
  8. Nephew or niece
The nearest relative must live in Britain and be over 18. The rights of the nearest relative include:
  • The right to information, for example, if a patient is to be detained or discharged under the Mental Health (Scotland) Act 1984.
  • The right to give consent to the patient being detained under Section 24 or the right to ask for a Mental Health Officer (MHO) to give consent instead.
  • The right to apply for detention - the nearest relative can make an application to the local sheriff court to have a patient detained, although this is not easy. More often the MHO will make the application.
  • The right to oppose a detention order - the nearest relative has the right to go to court when an application for detention is made by someone else.
  • The right to discharge a patient. If the patient is already detained, the nearest relative can try to discharge them from hospital.
  • The right to oppose detention continued after six months.
  • The right to oppose transfer to another hospital.
  • The right to apply for or to oppose guardianship.
  • The right to demand an MHO assessment from the social work department.
A legally appointed guardian can:
  • decide where the patient lives
  • arrange for the patient to attend for medical treatment
  • arrange for education or training for the patient.

Community Care Assessment and Consultation

Any adult over 16 is entitled to request a community care assessment to see whether they should receive community care services from the Social Work Department. If it is agreed that the person you care about should receive help, the information from the assessment will be written on a Care Plan. Your friend or relative should get a copy of both the assessment and Care Plan and, with their agreement, you too can request a copy.

Under the NHS and Community Care Act 1990, the carer has a right to be consulted at the time a Care Plan is being prepared, if he or she provides regular care and attention to that person.

If you are a carer who provides a lot of care on a regular basis, you are entitled to have your own needs taken into consideration when decisions are made about what services should be provided to the person you care about.

Under the Carers' (Recognition and Services) Act 1995, local authorities are legally obliged to carry out a separate assessment of the needs of the carer, if the carer requests this. Carers are entitled to an assessment when the person they care about has been assessed. A carer's assessment could help you with the following:

  • Support so that you don't have to cope on your own.
  • Breaks from caring so you have time to yourself.
  • Information about organisations and services which can help and about welfare benefits which can assist with the cost of caring.
If a service user has an issue which he or she does not wish a carer to know about, he or she may ask the professionals caring for him or her not to divulge this information to the carer.

Professionals, however, have to be guided by the Scottish Home and Health Department Code of Guidance on Confidentiality, which acknowledges:

  • The possibility of disclosure to enable someone else to provide health care to the user.
  • Circumstances where disclosure is in the best interests of the user.

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