Continuity and change – Mental Welfare Commission publishes its 2021-22 annual report

In its latest annual report, the Mental Welfare Commission highlights its concern over pressures on health and social care services, while underlining its own focus on continuity and change, putting the individual first.

The Commission’s roles include visiting wards and units across the country, talking to patients, relatives and staff and reviewing records. It publishes reports after each visit.

The Commission creates advice and guidance for health and care professionals on a range of issues, which last year included advice on vaccination when a person is unable to give consent, and guidance on excessive security.

2022 is the Commission’s 60th anniversary and while much has changed, the organisation retains the core focus of promoting a society where people with mental ill health, learning disability, dementia and related conditions are treated fairly, have their rights respected and have appropriate support to live the life of their choice.

Increased pressure on health and social care staff

Reflecting on the Commission’s engagement with patients, individuals and staff across Scotland last year, Sandy Riddell, chair, Mental Welfare Commission, said:

“We are seeing more examples of increased pressure on health and social care staff while demand for services remains high, and we are increasingly concerned about this. 

“It is partly due to the impact of the pandemic, but many of the difficulties experienced by mental health and social care services were evident before 2020. Staff vacancies and the resultant reliance on agency and bank staff only increase the pressure. 
“Pressure on staff of course has a direct impact on vulnerable patients. 

“While the economic outlook is increasingly difficult, we must never lose sight of the need to ensure that mental health and social care services for adults and children are safe, and people who need care and treatment are protected.”

Deliver the best services with tight resources

Considering the Commission’s own roles and responsibilities, Julie Paterson, chief executive, Mental Welfare Commission, said:

“In 2021-22 we continued to develop the organisation itself, in tandem with developing our ways of operating post-pandemic.

“This meant scrutinising the ways we work to deliver the best possible service with tight resources. We reviewed the vital input of our advisory committee, which includes representatives from 32 external organisations from across Scotland, aiming to increase their involvement. 

“We continued the process of increasing our engagement work, which is about connecting better with people in communities across Scotland. 

“We continued to build on our links with other national public sector organisations, seeking to create efficient routes of communication, and ensure we can effectively share expert advice and good practice – all vital activities, particularly during the very difficult times services are now facing.”

Activities in the year included:

• The Commission’s first report on racial inequality across mental health services in Scotland, found almost a third of health professionals who responded to its survey said they had seen or experienced racism directed at their NHS colleagues. It also found differences in the ways the Mental Health Act is applied when people from ethnic minorities are detained for care and treatment compared to white Scottish people, particularly between black women and white Scottish women. 
• The Commission’s report on mental health services in Scotland’s prisons found that, 10 years after a similar series of visits, there were many changes to structures and organisations, but little improvement in the outcome for prisoners’ mental health.
• After visiting services for people with alcohol related brain damage, the Commission found many individuals living in care homes where they are much younger than other residents; compelled to live in a setting they would never choose.
• At the request of Scottish Government, the Commission produced proposals for new systems of investigating deaths that take place when people are receiving compulsory care and treatment under mental health laws, and for investigating the care and treatment of perpetrators of homicide who had been in touch with mental health services prior to the homicide.
• Contributing to the recently-published Scottish Mental health Law Review, including providing three research briefs – one on second opinion doctors, one on compulsory treatment orders and one on the Commission’s own advice line.