Meaningful participation or tokenism for individuals on community based compulsory treatment orders? Views and experiences of the mental health tribunal in Scotland

Macgregor, A. (2022) Meaningful participation or tokenism for individuals on community based compulsory treatment orders? Views and experiences of the mental health tribunal in Scotland. Journal of Mental Health, 31(2), pp. 158-165. (doi: 10.1080/09638237.2020.1818708) (PMID:32955380)

Abstract

Background: The Mental Health (Care and Treatment) (Scotland) Act 2003 was considered as world leading when it was enacted due to its rights-based approach. Changes were made to encourage participation and enhance autonomy, including the Mental Health Tribunal for Scotland (the tribunal) replacing the Sheriff Court in making decisions about compulsory treatment. Aims: To explore the views of individuals on community based compulsory treatment orders (CCTOs) and independent advocates to assess whether participation in the tribunal is perceived as meaningful in practice. Method: A qualitative research design was adopted and semi-structured interviews were undertaken with 19 people with experience of being on a CCTO and eight mental health advocates in Scotland. The data were thematically analysed and explored using ethics of care principles. Results: Individuals faced barriers to participation, including mental distress, medication, and inaccessible communication, and both the tribunal process and outcome were important in shaping perceptions of fairness. A perceived unsuccessful outcome was found to undermine an ostensibly participatory process, and unequal power dynamics resulted in feelings of powerlessness. Conclusions: The findings suggest that participation is often experienced as tokenistic in practice and that cultural change is required if people are to be meaningfully involved in tribunal proceedings.

• Item Type: Articles
• Additional Information: This work was funded by the Economic and Social Research Council (ESRC) under Grant [1507915].
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Macgregor, Aisha
• Authors: Macgregor, A.
• College/School: College of Social Sciences > School of Social and Political Sciences
• Journal Name: Journal of Mental Health
• Publisher: Taylor & Francis
• ISSN: 0963-8237
• ISSN (Online): 1360-0567
• Published Online: 21 September 2020
• Copyright Holders: Copyright © 2020 The Author
• First Published: First published in Journal of Mental Health 31(2): 158-165
• Publisher Policy: Reproduced under a Creative Commons License