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SCOTTISH EXECUTIVE HEALTH DEPARTMENT MEMORANDUM OF PROCEDURE ON RESTRICTED PATIENTS

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ANNEX E
GUIDANCE ON TYPE OF INFORMATION REQUIRED WHEN CONSIDERING ABSOLUTE DISCHARGE

1. Current formulation:

  • Current understanding of situation by RMO;
  • RMO's current diagnosis and the state or presence of mental disorder of any kind; and
  • RMO's view of continuing risk to the patient themselves or the public.

2. Details of the patient's conduct under supervision:

  • A full comprehensive Community Care Assessment from local authority services to support the viability, safety and effectiveness of the proposed absolute discharge.
  • what is the multidisciplinary team's current understanding of the factors underpinning the index offence and previous dangerous behaviour;
  • what change has taken place in respect of those factors ( i.e. to affect the perceived level of dangerousness);
  • what is the outward evidence of change i.e. in relating to staff, patients and victim? Give specific examples;
  • how has the patient responded to stressful situations?;
  • has there been any physical violence or verbal aggression in the last year?;
  • co-operation with psychiatrist, overall mental health and current medication;
  • co-operation with social worker;
  • employment status/prospects; and
  • sexual attitudes and intimate relationships and their relevance.

3. An opinion from the RMO that the patient no longer presents a serious risk to the public.

4. Social situation:

  • resourcefulness, motivation;
  • personal and domestic hygiene;
  • way of spending their time;
  • employment status and prospects;
  • physical fitness/exercise taken;
  • interests and hobbies;
  • family contacts/support; and
  • social contacts.

5. Future Plans:

  • how the patient's situation would change, if at all;
  • what plans the patient has and how realistic these are;
  • whether the patient would continue in contact with social work and psychiatric services informally;
  • how contact might be expected to change;
  • whether the same support services would be available to the patient if given absolute discharge; and
  • what plans the services have in place in the event of relapse.

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Page updated: Wednesday, October 5, 2005