IT was with interest that I read Ulrich and Morag Fischer’s long letter (April 9) about the very difficult decisions clinicians are obliged to make in respect of mental health, and the availability of mental healthcare generally.

In the process of trying deal with and come to terms with the mental healthcare of family members, I have become aware of many issues that do not actually assist the appropriate clinical assessment of prospective mental health care patients.

It is very apparent that at the time of potential entry into the hospital setting, all earlier medical records need to be available to the clinician, social workers, mental health officer and other clinical staff, upon which to found their decisions.

This means that guardianship or power of attorney for welfare must be available to allow family members to scrutinise medical notes for correctness, omission and contradiction, at the time of any major clinical intervention.

I raise this issue, as after seven years of medical oversight elsewhere, in the case of my family the copious medical records were not available to those involved in decision-making, advice to family members, or the following prescription of anti-psychotic and anti-convulsant medication, for some four years in a hospital setting.

These notes were still not available during formal complaints as to whether the hospital setting was the most appropriate, nor at the commencement of the ombudsman complaint process, and I still was unaware that they had not been forwarded to the clinical teams, and unaware that the legal basis for care was dependent upon welfare guardianship that I didn’t yet have.

It later transpired that non-factual mental health medical statements were made to the sheriff for obtaining welfare guardianship, which were contradictory to the earlier records. So that’s 13 years going on 14 years without reference to the first seven years of mental health medical records.

This is just one of many problems regarding the treatment of mental health in the family, but perhaps it is one improvement that does not necessarily conflict with the current rationing of service provision and facilities for mental health issues for all ages.

For this reason, it would appear to be a good first step in mental health provision, to quality assure the medical records held by mental health hospitals, and encourage family scrutiny at the earliest possible dates that early legal permissions allow.

Stephen Tingle
Greater Glasgow

AS a retired mental health professional I fully endorse the comments of Ulrich and Mohrag Fischer in their long letter defending mental health services (April 9). I would go further and say that to focus solely on these services is a bit like focusing on firefighters trying to put out fires without asking why the fires are starting in the first place.

There are many and complex factors which increase the risk of suicide. Income inequality is one, so politicians who promote inequality by cutting higher tax rates while cutting benefits are “fire-raisers”. Suicide prevention needs a far wider vision than our present blinkered approach.

Derek Ball

I REFER to the wholly inaccurate assertion by a few MSPs that legalisation of assisted suicide somehow equates to a “soulless society”. Don’t these people understand that it is suffering individuals who are seeking this option, and that a truly soulless society is one that stands back from helping them?

Saturday was my 71st birthday and, I would argue, I am of sound mind. I did not suffer before I was alive and I will not suffer after I am dead therefore I have no fear of death, but I am concerned about dying.

I have seen two people I was close to, and their closer relatives, suffer over a long time the impacts of inevitable and debilitating deaths. That’s not for me, and I certainly do not wish it upon my children and grandchildren. So I have talked this through with my children, set out my reasons for the detail of my Advanced Medical Directive and explained the circumstances in which I want a one-way ticket to Switzerland.

This is my decision, and from that perspective I assert that it is a soulless society that will not afford me the assistance I would like but would instead ensure that I have to make the Swiss journey, thus denying my last service to the anatomy department of Glasgow University.

I suspect that some or all of those opposing the change to the law are, at least in part, motivated by their version of Christian mythology and I would ask them to reflect on the reality that the majority of Scots are not.

Archie Drummond