forensic training14 th september 2005 [email protected] the state hospital new legislation for...
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Forensic Training 14th September 2005 [email protected]
The State Hospital
New Legislation for Mentally Disordered Offenders
• Major Legislative Developments
• Interactions between the Criminal Justice and Mental Health Systems
• Specific Legislation
Forensic Training 14th September 2005 [email protected]
The State Hospital
Major Developments within the Mental Health (Care & Treatment) (Scotland) Act 2003
Principles
•Participation
•Respect for carers
•Informal care
•Least restrictive alternative
•Maximum benefit
•Non discrimination
•Respect for diversity
•Reciprocity
•Child welfare - paramount
•Equality
New Definitions
Mental Health Tribunal
Community Treatment Order
Services for Children
Services for Post Natal Depression
Patient Representation
•Advocacy
•Named Person
•Advance Statements
Assessment of Needs
Security Level Appeals
Urgent detention of acquitted persons
Forensic Training 14th September 2005 [email protected]
The State Hospital
Mental Health Legislation: Criminal
• Mental Health (Scotland) Act 1984
• Criminal Procedure (Scotland)Act 1995
• Crime and Punishment (Scotland) Act 1997
• Mental Health (Public Safety and Appeals) (Scotland) Act 1999
• Mental Health (Care and Treatment) (Scotland) Act 2003
Forensic Training 14th September 2005 [email protected]
The State Hospital
Criminal Justice and Mental Health Systems
Police - Place of Safety
- Informal treatment
- Emergency or Short-term Detention
Pre-Trial - Assessment Order) from court or
- Treatment Order) prison
- Assessment or Treatment as a condition of bail
Trial - Psychiatric Defences
Acquittal Conviction Acquittal on grounds of insanity
Urgent Detention Psychiatric Options for Disposal
of an Acquitted Person
Prison
- Transfer for Treatment Direction
Forensic Training 14th September 2005 [email protected]
The State Hospital
Legislation for MDOs
Power Before 2003 Act 2003 Act
Removal to a place of safety from public place
S.118 MH(S) A 1984 S.297 MH(C&T)(S) A 2003
Removal to a place of safety from private premises
S.117 MH(S) A 1984 S.293 MH(C&T)(S) A 2003
Removal to hospital for assessment
S.52 pre trial CP(S)A 1995 S.52 B-J CP(S) A 1995
Removal to hospital for treatment
- S.52 K-S CP(S) A 1995
Transfer of remand prisoner to hospital
S.70 MH(S) A 1984 S.52 B-J/S.52 K-S
Interim hospital/compulsion order
S.53 CP(S) A 1995 S.53 CP(S) A 1995
Forensic Training 14th September 2005 [email protected]
The State Hospital
Legislation for MDOsPower Before 2003 Act 2003 Act
Hospital/Compulsion Order S.58 CP(S) A 1995 S.57 A CP(S) A 1995
Restriction Order S.59 CP(S) A 1995 S.59 CP(S) A 1995
Hospital Direction S.59 A CP(S) A 1995 S.59A CP(S) A 1995
Guardianship S.58 (1A) CP(S) A 1995 S.58(1A) CP(S) A 1995
Intervention Order S.60B CP(S) A 1995 S.60B CP(S) A 1995
Compulsory Treatment in Community
- S.57 A CP(S) A 1995
Probation Order S.230 CP(S) A 1995 S.230 CP(S) A 1995
Transfer of sentenced prisoner to hospital
S.71+/- S.72 MH(S) A 1984 S.136 MH (C&J) (S) A 2003
Forensic Training 14th September 2005 [email protected]
The State Hospital
REMOVAL TO A PLACE OF SAFETY FROM A PUBLIC PLACE - POLICE
Section : 297Purpose : Medical ExaminationConditions : Police officer suspects mental disorder in a person in a public
place: In immediate need of care and treatment: In person’s interest or for protection of others
Powers : Detention in a place of safety for a medical examination Duration : 24 hoursSignatories : Police OfficerRevocation : NilAppeal : Nil
Forensic Training 14th September 2005 [email protected]
The State Hospital
Conditions for Detaining Mentally Disordered Offenders
• Mental Disorder• Treatment likely to alleviate symptoms or prevent
deterioration is available • Risk to health, safety or welfare of patient; or safety of
others• Making the order is necessary
No impaired decision making ability criterion for MDOsCourt: all circumstances / alternative means
Forensic Training 14th September 2005 [email protected]
The State Hospital
Remand to Hospital for Assessment
Section : 52 B-J Assessment Order CP(S) A 1995Purpose : Assessment in hospital prior to trial or sentencing.
From court or prisonEvidence : Written or oral from one registered doctorConditions : MD / Risk / Detention in hospital necessary to determine if
treatment order criteria met / Assessment could not be undertaken if patient not in hospital / bed
available in 7 daysPowers : Detention in hospital (Not treatment). RestrictedDuration : 28 days (7 day extension)Duties : RMO court report
: Social circumstances report Revocation or Variation : RMO applies to court
Forensic Training 14th September 2005 [email protected]
The State Hospital
Remand to Hospital for Treatment
Section : 52 K-S Treatment Order CP(S) A 1995Purpose : Treatment in hospital pre trial or sentencing.
From court or prison.Evidence : Written or oral from two registered doctor (1
approved)Conditions : MD / treatability / risk / bed available in 7 days
: Can be applied for directly or after an assessment orderPowers : Detention in hospital & treatment (Part 16). RestrictedDuration : No time limitDuties : RMO court reportRevocation or Variation : RMO applies to court
Forensic Training 14th September 2005 [email protected]
The State Hospital
Pre-sentence Inquiry into Mental or Physical condition
Section : 200 CP(S) A 1995
Purpose : To remand a convicted person in custody or on bail for assessment of
mental or physical condition. Bail, prison or hospital
Evidence : Written or oral from one registered doctor
Forensic Training 14th September 2005 [email protected]
The State Hospital
Pre-sentence Inquiry into Mental or Physical condition
Conditions : convicted of an offence punishable by imprisonment
: needs inquiry into mental or physical condition
Hospital : suffering from a mental disorder
: suitable hospital placement available
Overlap with S52 B-J / K-S
Duration : 3 weeks (extension for 3 weeks)
Duties : Court report prepared in hospital, community or prison
Revocation : Court
Forensic Training 14th September 2005 [email protected]
The State Hospital
Interim Compulsion Order
Section : 53 CP(S) A 1995
Purpose : inpatient assessment
Evidence : written or oral from 2 doctors (1 approved)
Conditions : MD / treatability / risk / bed available in 7 days
: likely compulsion and restriction orders or hospital direction
Not just State Hospital
Powers : detention and treatment in hospital (Part 16)
Duration : 3-12 months (12 weekly renewal)
Duties : RMO report / MHO – SCR
Revocation or Variation: no procedure/write to court
Forensic Training 14th September 2005 [email protected]
The State Hospital
Compulsion Order
Section : 57 A CP(S) A 1995Purpose : treatment in hospital or community (CTO)Evidence : written or oral from 2 doctors (1 approved)Conditions : MD / treatability / risk / hospital - bed available in 7 days
Convicted of an offence punishable by imprisonmentPowers : Part 16 treatment, attendance, access, residence
requirementsDuration : 6 months (+ 6 months annual)Duties : care planRevocation or Variation : Tribunal Non-compliance : as CTO
Forensic Training 14th September 2005 [email protected]
The State Hospital
Restriction Order
Section : 59 CP(S) A 1995Purpose : control of high risk patientsEvidence : oral evidence of 1 medical practitioner
: inpatient compulsion order: offence / antecedents / risk
Powers : Detention in hospital: Leave and transfer - Scottish Ministers
Duration : Without limit of timeDuties : RMO (annual) report
: MWC / Scottish Ministers
Revocation or Variation : Tribunal
Forensic Training 14th September 2005 [email protected]
The State Hospital
Restriction Order: review
Tribunal Review • RMO• MWC• Scottish Ministers• Patient• Named Person• Automatic – 2 years
Criteria• Mental Disorder• Treatability• Risk• Serious risk to others• Compulsion order necessary• Restriction order necessary - variation of compulsion order• Hospital necessary
Forensic Training 14th September 2005 [email protected]
The State Hospital
Tribunal Review: CORO
Outcome• Absolute discharge• Conditional discharge - defer?• Compulsion order – vary?• CORO
HearingAppeal – delays order
Forensic Training 14th September 2005 [email protected]
The State Hospital
Hospital Direction
Section : 59A CP(S) A 1995Purpose : combines hospital detention and prison sentenceEvidence : oral or written from 2 doctors (1 approved)
: doctors can recommend a hospital directionConditions : as compulsion order / link between mental disorder, offence +/- risk is
weakPowers : detention in hospital or prisonDuration : length of prison sentence / civil detention – C.T.O.Duties : RMO (annual) reports
: MWC / Scottish MinistersRevocation or Variation : Scottish Ministers & Tribunal : E.D.L.
: Parole : Release on life licence
Forensic Training 14th September 2005 [email protected]
The State Hospital
Tribunal Review: Hospital Direction
Criteria
• Mental Disorder
• Treatability
• Risk
• Serious risk to others
• Hospital direction necessary
Outcome
• Transfer to prison
• Hospital direction
Hearing
Forensic Training 14th September 2005 [email protected]
The State Hospital
Standard Procedures
Admission• in 7 days• place of safety• powers to convey – police,
hospital, otherAbscond• custody – hospital• inform court / Scottish Executive• revoke or vary order?
Suspension of detention• certificate by RMO • consent of Scottish Ministers• escort• length• location• time limits (TO, ICO, CORO, HD & TTD) • revocation RMO or Scottish Ministers
Forensic Training 14th September 2005 [email protected]
The State Hospital
Probation Order
Section : 230 CP (S) A 1995Purpose : medical or psychological treatment of a
mental conditionEvidence : oral or written by 1 doctor or a chartered
psychologist : mental disorder - needs treatment : CTO or CO not required : patient and CJSW agree
Forensic Training 14th September 2005 [email protected]
The State Hospital
Probation Order
Duration : 6 months 3 years
Duties : liaison with CJSW
: Social Enquiry Report
Variation : agreement of supervising officer
: inform court
Non compliance : notification to court
Forensic Training 14th September 2005 [email protected]
The State Hospital
Intervention and Guardianship Orders
Sections : S.60B CP(S) A 1995
: S.58 (1A) CP (S) A 1995
Purpose : personal welfare decisions or management (not financial)
Evidence : 2 medical reports ( 1 approved),/MHO report/3rd report
Conditions : found insane/offence punishable by imprisonment
: mental disorder
: compulsion order not required
: punishment not required
: incapacity for relevant matters
: personal welfare issues
Forensic Training 14th September 2005 [email protected]
The State Hospital
Urgent Detention of an Acquitted Person
Section : 134 MH (C&T) (S) A 2003 / 60C CP (S) A 1995
Purpose : for medical assessment re emergency or short term detention
Evidence: 2 medical recommendations for mental health disposal
: MD / treatability / risk
: not convicted
: not practicable to secure immediate examination
Powers : detention in a place of safety
Duration: 6 hours
Duties : medical examination
Forensic Training 14th September 2005 [email protected]
The State Hospital
Transfer for Treatment Direction
Section : 136 MH (C&T) (S) A 2003Purpose : treatment in hospital of sentenced prisonersEvidence : 2 medical reports (1 approved) to Scottish MinistersConditions : MD / treatability / risk / TTD necessary / bed available in 7
daysPowers : to transfer and treat in hospital, via a place of safety if
necessary. All restricted.Duration : length of prison sentence Duties : RMO (annual report) Revocation or variation : Scottish Ministers or Tribunal : E.D.L.
: Parole : Release on life licence