Mental Welfare Commission releases 2018-19 annual report

The Mental Welfare Commission today published its annual report for 2018-19.

Highlights of the year include the government’s announcement of a review of the Mental Health Act, something the Commission had been calling for over recent years, along with reviews of linked legislation. Colin McKay, Commission chief executive, has been appointed one of a small team of advisers working on the review.

Key projects for the Commission include a major investigation into the case of a vulnerable woman who remained in hospital until 18 months after she had been deemed fit to leave. The delay was due to a prolonged dispute between her family and social work professionals. The Commission outlined what went wrong and when, and called for better joint working between health and social care services.

Between January and December 2018 the Commission carried out 125 visits to individuals in hospitals, secure units, specialist units and prisons. Reports are published after each visit, highlighting findings on the day and giving recommendations for improvement where needed.

The Commission produced a new good practice guide on carers and confidentiality. The document advises doctors, nurses and other professionals on how to respect patient confidentiality while also involving families and carers in treatment. It follows concerns from families that they were often not included when decisions were made about their loved ones.

The complex issue of seclusion was the subject of another good practice guide, which updated the definition of seclusion and asks that every health board in Scotland now produce a policy on its use, whether or not they say they use it.

Care plans – vital documents that describe the care and treatment an individual should receive – were also the subject of a good practice guide, shared with wards and units across Scotland.
Colin McKay, chief executive of the Mental Welfare Commission, said: 

“We welcomed the Scottish Government’s commitment to review of the Mental Health Act and related legislation, and will do all we can to support its progress.

“As we discuss options and listen to views about how best to create modern, forward looking legislation, it is critical to keep a strong connection with what is happening now for people across Scotland. On the pressures on services, the changing needs of the population, and the way the law is being used now.

“Our monitoring report on the use of the Mental Health Act is a key document – the
only publication that collates national data on how the law is being used to treat people with mental ill health. The 2018-19 report shows an increased use of the law to detain people for treatment. This reflects previous years and means we now have the highest rate of detentions yet recorded using the 2003 Mental Health Act, with variations in how it is happening across the country. It also shows significant rises in detentions related to young people. 

“The review of the Act will look at why detentions overall are increasing, and why there are variations across Scotland. These are key questions which we must seek to answer before new laws can be put in place.

 “In our wider work, we undertook our first themed visit to people with autism, with our report focusing on those who also had complex needs. We hope our findings will be helpful to services and families, and will help drive improvements in the areas we highlight in our recommendations.

“Overall, we know that services are working hard, often with stretched resources. We highlight good practices when we see it, but we will also continue to raise questions and make recommendations when we believe improvements are needed.”

Impact

A key achievement in terms of The Commission’s own impact highlighted in the annual report relates to perinatal mental health. Two earlier reports by the Commission found gaps in services for new mothers and mothers-to-be who had mental ill health. The Commission worked with others to highlight its recommendations for change, which the government accepted; their continued commitment is reflected in the current Programme for Government, with clear finances attached.

Improving practice

The Commission made a number of improvements in its own practice in 2018-19. A major office refurbishment reduced the amount of office space used, reducing costs while creating a new office environment and introducing more flexible work practices. 

The Commission website was updated, making it more secure and user-friendly.

Chairman

The Very Revd Dr Graham Forbes completed his term of office as chair of the Commission’s Board on 31 March 2019, and was succeeded by Sandy Riddell.