Scottish Psychiatrists 'Slightly More Positive' About The Mental Health Act

Main Category: Psychology / Psychiatry
Also Included In: Mental Health
Article Date: 30 Nov 2008 - 1:00 PDT

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Psychiatrists in Scotland are starting to view the new Mental Health (Care and Treatment) (Scotland) Act 2003 a little more positively, according to the results of a survey published in the December issue of the Psychiatric Bulletin.

Overall, levels of satisfaction among psychiatrists rose between 2006 and 2007. But the survey also shows that many psychiatrists still harbour concerns - with 43% remaining unsatisfied or very unsatisfied with the Act. Furthermore, over two-thirds still don't believe that patient care has improved.

Researchers Dr Andrew Donaldson, Dr Christine Carswell and Dr Keith Brown carried out an initial survey of psychiatrists' views in early 2006 - just a few months after the new Act came into force in Scotland in October 2005. One year on, in March 2007, they carried out a repeat survey to investigate whether psychiatrists' opinions had changed.

In the second survey, 237 members of the Royal College of Psychiatrists in Scotland completed an anonymous one-page questionnaire. Over half of respondents (54%) said they were either satisfied or very satisfied with the new Act in 2007 - up from 37% in 2006. In addition, 51% of the 2007 respondents said they would choose to use the new Act in preference to the previous Act of 1984.

According to the researchers, an increase in satisfaction with the Act over time "would be expected as psychiatrists become more familiar with the procedures and paperwork". However, the survey shows that significant areas of concern remain.

Writing in the Psychiatric Bulletin, the researchers said: "Although there may continue to be further improvement in the future, there is clearly still a considerable degree of dissatisfaction with the Act at present, with 43% of respondents unsatisfied or very unsatisfied. In the second survey, there was a statistically significant increase in respondents who felt that patient care had improved, but 69% of psychiatrists continued to express the view that patient care had not improved with the new Act."

In addition, the vast majority (89%) of psychiatrists questioned in 2007 felt their daytime workload had increased as a result of the new Act - with some blaming "overly bureaucratic and time-consuming" paperwork. A further 40% reported an increase in their out-of-hours workload.

Although additional funds were made available from the Scottish Executive for implementing the new Mental Health, only 17% of respondents reported receiving additional payments for the Mental Health Act work. Commenting on this discrepancy, the researchers said: "This increased workload without additional financial compensation may have a detrimental effect on morale and recruitment."

They concluded: "Overall, psychiatrists appeared to view the 2003 Mental Health Act a little more positively than they did the preceding year. However, there are still significant areas of concern which need to be addressed. We hope this repeat survey helps identify some of these concerns and ultimately leads to improvements in the working of the Act."

Reference:
"1 year on: how psychiatrists feel about the Mental Health Act (Care and treatment) (Scotland) Act 2003"
Donaldson A, Carswell C and Brown K (2008)
Psychiatric Bulletin, 32: 464-466

British Journal of Psychiatry

Royal College of Psychiatrists