Mental Welfare Commission recommends urgent action to reduce and eliminate routine daytime confinement at State Hospital

The Mental Welfare Commission for Scotland (the Commission) has previously raised concerns about the use of daytime confinement  at the State Hospital. Its latest visit, in July 2026, found no progress on this issue. The Commission therefore recommends that the State Hospital Board take urgent action to reduce and eliminate the routine use of daytime confinement arising from staffing or operational pressures.

About the Commission’s visit to the State Hospital

In July 2026, the Commission undertook an unannounced, enhanced visit to the State Hospital to follow up on issues identified in previous visits, particularly the ongoing use of daytime confinement. The Commission’s enhanced visit approach differs from a standard visit arrangement, by extending the Commission’s presence in a particular setting to more than a single day. This allows the Commission to gather feedback from more families, staff, patients, mental health officers, and advocacy workers, and to review a greater number of care records.  

Definition of daytime confinement  

In the Commission’s report, daytime confinement refers to periods during the day when a person is required to remain in their bedroom and prevented from accessing the usual ward areas, hub, grounds or therapeutic activities. It is not imposed because of individual risk or clinical needs of the person, but arises directly from insufficient staffing and associated operational pressures at the State Hospital. It is distinct from seclusion, which may be imposed on an individual following an assessment of their clinical needs or risks.

About the State Hospital

The State Hospital is a psychiatric hospital, located in South Lanarkshire, which provides care and treatment in conditions of high security for people from Scotland and Northern Ireland. It is a Special Health Board, part of NHS Scotland and the only hospital of its kind within Scotland.

Claire Lamza, executive director (nursing), Mental Welfare Commission for Scotland said:

“The Commission has repeatedly highlighted the need to address the issue of daytime confinement at the State Hospital, and it is not acceptable that no progress was found during our latest visit. The routine use of daytime confinement because of staffing or operational pressures must be reduced and eliminated.  

We urge the State Hospital to act urgently, with a clear improvement plan and Board oversight, and ensure that any restriction is necessary, proportionate and individually reviewed. This matters because daytime confinement affects people’s access to therapeutic activity, clinical contact, mental health and wellbeing, rehabilitation and progression to less restrictive settings.

The State Hospital already benefits from strong multidisciplinary team working and good care planning. Reducing and eliminating daytime confinement will allow that work to deliver its full benefit.”