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The resources released from the closure of continuing care inpatient beds at the Jeannie Deans will be used to develop and enhance community care services that will improve access to local services enabling older people to stay within their homes for as long as possible. These include preventative, anticipatory and rehabilitative care; increased rapid intervention to prevent admission and support early discharge, and increased access to respite and day care.

I considered all available information in coming to a view on NHS Highland and Argyll and Bute Council’s proposals to redesign older people’s services in Helensburgh and Lomond. I am aware that the Social Work Inspection Agency (SWIA) are carrying out a programmed performance inspection of Argyll and Bute Council and that the report is due to be published in October.

SWIA inspection reports set out clear recommended actions for local authorities and these should address any concerns that there might be regarding sustainable alternative services. However, I would stress that both NHS Highland and Argyll and Bute Council have committed themselves to providing the required community based services which will be enhanced by the resources released through the closure of Jeannie Deans Unit.

Under current legislationperiodic reviews mean that MEP numbers are determined with reference to actual numbersof electors.

Regular meetingstake place with NHS boards and local authorities to discuss a wide range ofmental health issues. Most recently, meetings with NHS board chief executiveson 20 June, and NHS board chairs on 23 July included a progress report on themental health agenda.

Other meetingsinclude the NHS board annual reviews which take place over July to December,and the twice yearly implementation reviews with NHS boards, Local Authorities andother partners as part of the on-going monitoring process for the commitmentsand targets around Delivering for Mental Health (Bib. number 41410); the Mental Health of Children and Young PeopleFramework (Bib. number38415); and implementation ofRights, Relationships and Recovery, the national review of mental healthnursing (Bib. number: 43282).Following visits earlier inApril/May these will continue in October/November this year and beyond.

Since theimplementation of the Mental Health (Care and Treatment) (Scotland) Act 2003, (the 2003 Act), the Executive hasencouraged better use of short-term detention certificates which are intendedfor assessment and/or treatment of people in hospital. TheMental Welfare Commission for Scotland, who have a duty to monitor theoperation of the 2003 have reported that the rate of emergency detentionremains much lower that it was before the 2003 Act was implemented. Short-termdetention is now the usual route into compulsory treatment during normalworking hours and 70% of emergency orders aregranted outside normal working hours.

Takentogether, the 2000 Act, the 2003 Act and the Adult Support and Protection (Scotland) Act 2007, (the 2007 Act)provide a comprehensive framework for supporting, protecting and safeguardingthe interests of vulnerable adults in Scotland. Each piece of legislation has a different focus. The 2003 Actcomprehensively reforms and modernises the legal framework for treatment anddetention of people with mental disorder. The 2000 Act ensures that measuresare in place to safeguard and have decisions made on behalf of adults who lackcapacity to make the decisions themselves, including decisions relating tomedical treatment. The 2007 Act introduces measures to better protect adults atrisk of abuse.

Somepeople who are unable to give informed consent to treatment may be subject tomore than one piece of legislation, depending on the circumstances and care andtreatment required. The Mental Welfare Commission for Scotland has produced guidance on consent totreatment and the codes of practice for the Acts will contain helpful guidance.

Our approach tomental health has a wholepopulation focus to maintainthe mental wellbeing of the people of Scotland; andimprove the situation of those with mental ill-health. The approach focuses onpromoting attitudes and behaviour which leads to improved mental wellbeing; andensuring high quality, integrated mental health services are available foreveryone that needs them, at all levels of need.

Our whole systemsapproach to the delivery of mental health services is based on partnershipworking across NHS boards,CHPs; local authorities, the voluntary sector and others to deliver on a rangeof policies and initiatives. These include delivery of the 14 specific and timetabledcommitments and 3 HEAT targets set out in Delivering for Mental Health (Bib. number:41410).

Progress withdelivery by local agencies on this agenda is assisted and informed by a rangeof national support mechanisms. These include the Mental Health Collaborativewhich will help deliver targets around reducing readmissions and antidepressantprescribing; benchmarking and information gathering to support the improvementprocess and publication later this year of standards for Integrated CarePathways for the main mental health diagnosis. Development of betterperformance management systems, such as visits to every NHS board in Scotland to review implementation and offer support forchange, will also assist delivery by all agencies.

Therehas been a small overall rise in people with learning disabilities who aresubject to compulsory detention under the Mental Health (Care and Treatment)(Scotland) Act 2003 (the 2003 Act). The numbers have risen from 239 people in2004 to 252 people in 2006. Peoplewith learning disabilities have a higher incidence of mental health difficultiesthan the general population. There is also some evidence that they are subjectto orders for longer periods.

Peoplewith learning disabilities (with or without a co-morbid mental illness) havethe same rights and safeguards under the 2003 Act as other mental healthservice users. The Mental Welfare Commission for Scotland visits all people on long term ordersand provides an important safeguard for people with learning disabilities whomay not be able to make representations to the Tribunal.

The admissionrate for males under the Mental Health Act has been consistently higher thanfor females in the years 2000–05 (the latest years for which we have completedata). There is also a much greater tendency for men to be subject to mentalhealth orders following a criminal order. This is a complex area and it is notpossible to ascertain whether this reflects differential need between males andfemales or whether there is any systematic bias in the system.

Once admitted tothe psychiatric unit, there is no evidence of any significant difference inlength of hospitalisation between males and females.

I refer the memberto the answers to questions S3W-2593 and S3W-2595 on 21 August 2007. All answers to written parliamentary questions are available on the Parliament’swebsite, the search facility for which can be found at http://www.scottish.parliament.uk/webapp/wa.search.