A review of Scottish mental health legislation has echoed proposals south of the border by calling for compulsory treatment orders in the community and new systems to deal with mentally disordered offenders.

The review of the Mental Health (Scotland) Act 1984 is the result of two years'work by a committee led by former Scottish secretary Bruce Millan. The Scottish Executive will respond in the summer with a policy statement laying out proposals for legislative change.

But the Millan proposals have met the same kind of anger from charities north of the border as the policy changes in England and Wales originally faced.

The Mental Health Foundation said the reforms were 'unworkable and impracticable'. While compulsory treatment in the community is 'well-intentioned', the proposals could increase the potential for conflict between mental health users and staff.

Maddy Halliday, Scotland director of the foundation, said the recommendations in the Millan committee review could hold many people back from seeking the support that they need.

The foundation claimed that its own research showed 'nearly one in five people with mental health problems are already unwilling to talk to GPs about their mental health, but how many more people will be scared of approaching their GP if they think the end result may be compulsory treatment in their own home?'

Chief executive of the Scottish Association for Mental Health Shona Barcus told HSJ: 'This recommendation is almost a response to a lack of community facilities. '

If those existed there would be 'less need for compulsory detention', she said. But it was important not to get 'too hung up' on the 'more controversial' aspects. 'There is a lot of innovative stuff in here and I find myself internally applauding many of its conclusions. '

She welcomed the 'general tenor' of the 400 or so recommendations, which include a new Mental Health Act, sheriff courts to be replaced by a new independent tribunal in considering compulsory measures, and a more systematic approach to risk assessment and management for those with mental disorders who commit serious offences.

Scottish ministers should give up their role regarding these restricted patients, says the report, and give responsibility to a parole board sitting as a restricted patients review board. If implemented, the legislation would 'set the Scottish health service ahead of many others around the world'.

The British Medical Association in Scotland said the review offered a 'constructive way forward'.

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