The Psychiatrist (2004) 28: 248-250. doi: 10.1192/pb.28.7.248
© 2004 The Royal College of Psychiatrists
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Psychiatric Bulletin (2004) 28: 248-250
© 2004 The Royal College of Psychiatrists

Difficulties with use of the Mental Health (Scotland) Act 1984 by general practitioners in rural Scotland

Millia Begum, Psychiatric Senior House Officer

Argyll and Bute Hospital, Lochgilphead, Argyll, PA31 8LD

Rebecca Helliwell, General Practice Vocational Senior House Officer

Argyll and Bute Hospital

Angus Mackay, Physician Superintendent, Director of Mental Health Services for Lomond and Argyll

Argyll and Bute Hospital

Declaration of interest

None.

AIMS AND METHOD

Anecdotal evidence suggests that considerable difficulties are experienced in rural areas by isolated general practitioners, when detaining patients under the Mental Health (Scotland) Act 1984. The aim of this study was to identify the range and extent of these difficulties in a structured way, and to identify ways of responding to them. A postal questionnaire was sent to 85 general practitioners in a sparsely populated area of Scotland to assess their experience of emergency detention.

RESULTS

The questionnaire response rate was 62%. Considerable difficulties were recorded from those who responded, notably their lack of support with clinical management during the delay between the patient’s detention and the arrival of psychiatric staff, the lack of satisfactory places of safety for the patient during this period, and the difficult logistics of safe and satisfactory transport to hospital.

CLINICAL IMPLICATIONS

Rural general practitioners and their patients appear to be disadvantaged through lack of coordinated help in the management of inherently difficult and risky clinical situations. Even without additional resources, the process could be improved through coordinated, multi-agency action plans which take account of local conditions.