1. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital New Legislation for Mentally Disordered Offenders Major Legislative Developments Interactions between the Criminal Justice and Mental Health Systems Specific Legislation

2. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk 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

3. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk 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

4. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk 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 AcquittalConviction Acquittal on grounds of insanity  Urgent Detention Psychiatric Options for Disposal of an Acquitted Person Prison - Transfer for Treatment Direction

5. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Legislation for MDOs

6. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Legislation for MDOs

7. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital REMOVAL TO A PLACE OF SAFETY FROM A PUBLIC PLACE - POLICE Section: 297 Purpose: Medical Examination Conditions: 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 hours Signatories: Police Officer Revocation: Nil Appeal: Nil

8. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk 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 MDOs Court: all circumstances / alternative means

9. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Remand to Hospital for Assessment Section: 52 B-J Assessment Order CP(S) A 1995 Purpose: Assessment in hospital prior to trial or sentencing. From court or prison Evidence: Written or oral from one registered doctor Conditions: 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 days Powers: Detention in hospital (Not treatment). Restricted Duration: 28 days (7 day extension) Duties: RMO court report : Social circumstances report Revocation or Variation : RMO applies to court

10. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Remand to Hospital for Treatment Section: 52 K-S Treatment Order CP(S) A 1995 Purpose: 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 order Powers: Detention in hospital & treatment (Part 16). Restricted Duration: No time limit Duties: RMO court report Revocation or Variation : RMO applies to court

11. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk 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

12. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk 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

13. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk 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

14. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Compulsion Order Section: 57 A CP(S) A 1995 Purpose: 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 imprisonment Powers: Part 16 treatment, attendance, access, residence requirements Duration: 6 months (+ 6 months  annual) Duties: care plan Revocation or Variation : Tribunal Non-compliance: as CTO

15. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Restriction Order Section: 59 CP(S) A 1995 Purpose : control of high risk patients Evidence: 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 time Duties: RMO (annual) report : MWC / Scottish Ministers Revocation or Variation : Tribunal

16. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk 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

17. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Tribunal Review: CORO Outcome Absolute discharge Conditional discharge - defer? Compulsion order – vary? CORO Hearing Appeal – delays order

18. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Hospital Direction Section: 59A CP(S) A 1995 Purpose: combines hospital detention and prison sentence Evidence: oral or written from 2 doctors (1 approved) : doctors can recommend a hospital direction Conditions: as compulsion order / link between mental disorder, offence +/- risk is weak Powers: detention in hospital or prison Duration: length of prison sentence / civil detention – C.T.O. Duties: RMO (annual) reports : MWC / Scottish Ministers Revocation or Variation : Scottish Ministers & Tribunal : E.D.L. : Parole : Release on life licence

19. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk 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

20. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Standard Procedures Admission in 7 days place of safety powers to convey – police, hospital, other Abscond 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

21. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Probation Order Section: 230 CP (S) A 1995 Purpose: medical or psychological treatment of a mental condition Evidence: oral or written by 1 doctor or a chartered psychologist : mental disorder - needs treatment : CTO or CO not required : patient and CJSW agree

22. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk 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

23. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk 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

24. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk 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

25. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Transfer for Treatment Direction Section: 136 MH (C&T) (S) A 2003 Purpose : treatment in hospital of sentenced prisoners Evidence: 2 medical reports (1 approved) to Scottish Ministers Conditions: MD / treatability / risk / TTD necessary / bed available in 7 days Powers: 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

26. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Appeals against Excessive Security Sections: 264-273 MH (C&T) (S) A 2003 Conditions: CTO, CO, HD, TTD - 6 months Applicant: patient, named person, guardian, welfare attorney, MWC Frequency: once per12 months State Hospital: patient requires conditions of special security & such conditions can only be provided in a State Hospital Appeal: Tribunal Outcome: Order agrees : 3 months for Health Board to identify a hospital (Scottish Ministers to agree for restricted patients) : If not moved - further hearings

27. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Transitional Provisions Scottish Executive August 2005 Hospital Order  Compulsion Order Immediate S.18  CTO S.76 Care Plan as soon as reasonably practicable (Part 9 Care Plan?) Any 1984/1995 Act court proceedings on going at commencement will continue to end of that stage of legal process. A final disposal will immediately convert to “new” Act. All pre-sentence criminal orders or S.70 live at midnight on 4/10/05 will run their course. Any subsequent orders will be made under “new” 1995 Act.

28. Forensic Training14 th September 2005 L.D.G.Thomson@ed.ac.uk The State Hospital Reference McManus, J.J. and Thomson, L.D.G. (2005) Mental Health and Scots Law in Practice. Publishers: W. Green & Sons, Edinburgh. ISBN: 0414014758