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

Figures & data

Table 1. Extract from topic guides.

Individuals

Have you attended any mental health tribunals? Probe reasons for attendance/non-attendance. Can you describe what happened? Do you feel you were listened to? In what ways? What was the outcome? How did you feel about this? Did you have an advocate? How did you feel about this? Do you have an advance statement? Probe around the reasons for uptake/lack of uptake. What does your advance statement say? Has it been taken into account? Probe around this.

Advocates

What does the advocacy role involve? How do advocates support individuals on CCTOs? What information is given to individuals in advance of the tribunal? How is this provided? Can you talk me through what happens at the tribunal? Is there an order to proceedings? What are your views about the level of formality? How much do individuals participate in tribunals? In what ways? Are people supported to participate? Are there any barriers to participation? Are the views of individuals on CCTOs taken into account? In what ways? Is this reflected in tribunal outcomes? What evidence is given to fulfil the legislative criteria? What are your views of advance statements? How are they used? How often are they overturned?

Table 2. The influence of the feminist ethics of care on the analysis.

This was conducted as part of a second order analysis to develop the thematic analysis

Adapted from Tronto’s (1993) Integrity of Care Framework Attentiveness: recognising and being attentive to the needs of others. This involves knowing a person, their likes, dislikes, wishes and preferences. This requires a holistic understanding of needs, not just medical needs, and recognition of those produced by both mental distress and the mental health system itself. Responsibility: taking responsibility to meet identified needs. This must come from a genuine place of care rather than obligation (Sevenhuijsen, 2003). Competence: focuses on the outcomes of caring practices. Good intentions are not enough; adequate resources and trusting relationships are important if good care outcomes are to be achieved (Brannelly, 2016). Responsiveness: promotes voice and requires listening to care and treatment preferences. Having voice is significant for people whose agency has been eroded because of assumptions about mental illness (Tew, 2011). Power and Trust: good care is grounded in trusting relationships, which is interwoven with issues of power (Lynch et al., 2009). An ethics of care requires moving “the interrelated factions of care, dependency, vulnerability and power from the background to the foreground” (Ward, 2011, p. 172).

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