Sir: A postal survey was conducted (April 1996-June 1997) to determine the attitudes of consultant psychiatrists working with adult, adolescent or psychogeriatric patients in the Wales Region towards the new legal powers.
After 12 weeks there had been a 31% (107/300) response rate. Only six patients in total were placed on supervised discharge by three of the 107 respondents. Twenty-eight of the 107 respondents stated that they had considered using the new legislation regarding supervised discharge, although 53 had reservations.
Three aspects caused concern when the respondents were asked about the factors that influenced the decision to recommend supervised discharge. Supervised discharge would generate an increased workload, for which resources are not available (5/107); there was no sanction on the patient if he or she did not comply (30/107); and, properly resourced community care could be used instead of supervised discharge (27/107). Several respondents commented that the legislation was insufficient in its powers and that the legislation would not be appropriate for patients lacking insight.
Respondents felt that confusion existed while processing the paperwork and the forms need to be simplified and clarified in order to avoid unnecessary time consumption.
Although the Act introduces a new somewhat convoluted system of procedures for supervised aftercare, and has serious implications for both human rights and the relationship between care professionals and their service users, it is difficult to see it as an improvement on the possibilities for intervention under current legislation. The fact is that there are no new powers and these patients still have to deteriorate and then be readmitted compulsorily before they can receive the treatment they need.
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