Changes to Supervised Community Treatment: Fair or Unfair?
This article examines the changes made to supervised community treatment (SCT) legislation, introduced in June 2012. Capacitous patients no longer require a second opinion approved doctor (SOAD) to approve their treatment. Prior to these changes capacitous, consenting patients required their treatment to be approved by a SOAD. This situation was unique in that no other capacitously consenting patients in any area of mental health practice required this form of approval. Additional concerns had been raised that emergency sections of the Mental Health Act were being used because of problems with availability of SOADs. We analyse SCT and these changes from the perspective of values based practice and in terms of fairness. Fairness is discussed with reference to Rawls' account and William's view of fairness as equality. We argue that recent changes make SCT more fair, in the sense that equality has been established regarding approval of treatment between individuals detained under the Mental Health Act on the wards and community SCT patients. The changes also mean that emergency treatment sections will no longer be used in this situation as capacitously consenting patients will not have to wait for a SOAD visit