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Health Care Standards

Health Care Standard 3

Mental Health Services

Standard Statement

To promote mental wellbeing and provide mental health care within an integrated multidisciplinary mental health service.

3.1.1CRITERIA: Organisational and Infrastructure

  1. The Mental Health (Care & Treatment) (Scotland) Act 2003 and associated Codes of Practice will be available in each health centre and to all healthcare staff.
  1. All healthcare staff, Multi Disciplinary Mental Health Team (MDMHT), Dep Governor and Governor will be aware of the guiding principles of the Mental Health (Care & Treatment) (Scotland) Act 2003.
  1. SPS Guidance Notes on the implementation of the Mental Health (Care & Treatment) (Scotland) Act 2003 will be available in each health centre for all staff to access.
  1. The Scottish Prison Service policy document ‘Positive Mental Health’ will be available in each establishment.
  1. Establishments will utilise “Taking Steps: A Mental Health Pathway for Prisoners”within their primary health care and multi-disciplinary mental health care practices.
  1. Each establishment will have and operate an MDMHT as stated in “Positive Mental Health”, which will also include mental health nursing staff.
  1. There is evidence of continuous Mental Health First Aid Training within the establishment.
  1. Each establishment will have an arrangement in place to provide, on a sessional basis,

Consultant Psychiatric services to prisoners.

  1. There is evidence that care plans have been developed in partnership, agreed with the prisoner and endorsed by the MDMHT; and where this has not occurred just reasoning is provided on the care plan and within the mental health notes.
  1. There will be evidence of MDMHT working links with community Mental Health Services.
  1. There is evidence of co-ordination of transitional care for Mentally Disordered Offenders, including attendance at external Care Programme Approach (CPA) meetings, and initiation of CPA within establishment in preparation for liberation.
  1. Prisoners who are assessed as requiring compulsory care under the Mental Health Act will be transferred within 7 days of an assessment order, treatment order or transfer for treatment direction being made.

3.1.2CRITERIA: Mental Health Services

  1. MDMHT meetings will be chaired by a Senior Operational Manager, held at a minimum of every two weeks and will be minuted.
  1. A referral system will be in place that ensures all referrals are made to the MDMHT.
  1. Emergency referrals of prisoners with acute mental health needs will be seen by a nurse within 24 hours.
  1. Upon receipt of a referral, a Mental Health nurse will carry out a mental health assessment within 72 hours.
  1. Written evidence will show that the Prisoner has given informed consent allowing his care to be shared within the MDMHT.
  1. Where a patient has refused consent to MDMHT participation, evidence will demonstrate the delivery of critical care to meet any immediate need.
  1. Ongoing cases will be discussed and reviewed by the MDMHT to match individual needs or every three months whichever comes first.
  1. MDMHT Case management processes will contribute to the SPS Integrated Case Management system (ICM) for prisoners with mental health problems.
  1. When prisoners refuse or fail to attend for medication associated with their mental health, a clinical assessment of their condition will be undertaken within 24 hours.
  1. Failure of a prisoner to attend for an appointment with a member of the MDMHT will be investigated within 24 hours.
  1. Prisoners currently managed under MDMHT will not be transferred to other establishments without the explicit written consent, including email, of a MDMHT member.

3.2CRITERIA: Care Interventions

1.Arrangements will be in place for the provision of Mental Health Independent Advocacy services.

2.All prisoners engaged with the MDMHT or managed directly by a visiting Consultant Psychiatrist will have an up to date mental health care plan contained within their healthcare records

3.There will be evidence of a tiered model of mental health care, including self help, within their healthcare records.

4.Where a prisoner with mental health problems also has an identified substance misuse there will be evidence of joint working and integrated care planning.

5.Prisoners who have an assessed need will have access to psychological interventions.

6.All prisoners with mental health needs will have an individual care plan in-situ that includes engagement in meaningful therapeutic activity.

7.Patients will be actively involved in the management of their illness and their treatment unless clinically contra-indicated. Where this is the case just reasoning will be detailed in the patient’s mental health notes.

3.3CRITERIA: Mental Health (Care and Treatment) (Scotland) Act 2003

  1. All health care professionals, MDMHT members, Dep Governor and Governor will adhere to the provisions and principles of the Mental Health (Care and Treatment) (Scotland) Act 2003and Criminal Procedures (Scotland) Act 1995.
  1. All health centre staff and MDMHT members will have access to and an awareness of Adult Support and Protection Act (Scotland) 2007 and Adults with Incapacity (Scotland) Act 2000.

REFERENCES:

Adult Support and Protection Act (Scotland) 2007

Adults with Incapacity (Scotland) Act 2000

Mental Health (Care & Treatment) (Scotland) Act 2003

Rights, Relationships and Recovery (SEND 2006)

Scottish Executive (2005) Mental Health (Care & Treatment) (Scotland) Act 2003. Code of Practice Volume 1. Scottish Executive. Edinburgh

Scottish Executive (2005) Mental Health (Care & Treatment) (Scotland) Act 2003. Code of Practice Volume 2. Scottish Executive. Edinburgh

Scottish Executive (2005) Mental Health (Care & Treatment) (Scotland) Act 2003. Code of Practice Volume 3. Scottish Executive. Edinburgh

SPS (2002) Positive Mental Health Rehabilitation& CareDirectorate, SPS

SPS (2005) Mental Health (Care and Treatment) (Scotland) 2003 Revised Guidance on the Transfer of Prisoners into the mental health system for assessment or treatment Health and Care Directorate SPS

SPS Healthcare Standards 10. Prescribing for Clinical Management of Drug and Alcohol Dependency SPS

SPS& SCOT PHN. Taking steps: A Mental Health Pathway for Prisoners. Workbook.

SPS & SCOT PHN Taking steps: A Mental Health Pathway for Prisoners. User book.

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2010/11HCS3