The end of indefinitely renewable leave of absence in Scotland: the impact of the Mental Health (Patients in the Community) Act 1995

Atkinson, J.M. and Garner, H.C. and Harper Gilmour, W. and Dyer, J.A.T. (2002) The end of indefinitely renewable leave of absence in Scotland: the impact of the Mental Health (Patients in the Community) Act 1995. Journal of Forensic Psychiatry and Psychology 13(2):pp. 298-314.

Abstract

The Mental Health (Patients in the Community) Act 1995 restricted leave of absence (LOA) for detained patients in Scotland to 12 months. This study looked at the impact on patients who were affected by this restriction. A total of 266 patients were identified from Mental Welfare Commission records: 194 reached the new maximum, 47 were 'transitional', 16 were on improperly long LOA and 9 were on community care orders (CCOs) following LOA but not maximum LOA. Of this 194, 12 were transferred to guardianship and the remainder became voluntary patients. The responsible medical officers (RMOs) would have liked to renew LOA for 71% of patients. In 90% of cases RMOs renewed LOA to ensure compliance with medication. Patients were significantly more likely to be compliant with medication while on LOA than post-LOA. A minority (28%) were recorded as being involved in 'incidents' post-LOA. There were 37% who were known to have a substance use problem in their management. The results suggest that RMOs may have been conservative in using LOA.