Significant rise in numbers of people being detained for mental health treatment in Scotland

The number of times people in Scotland were so unwell that they were detained for mental health treatment rose by 10.5% in 2020-21.

This compares to an average 4.5% rise over the previous five years, more than doubling the rise.

As well as rising numbers, the report once more showing falling safeguards when people are detained for treatment against their will.

For the first time the report also compares levels of detention with deprivation, and finds a clear link between detention for serious mental ill health and poverty. 

Rising figures across all detentions

The new figures confirm that there were 6,699 episodes – each episode being a single period of time one individual is detained for - using the Mental Health Act in Scotland in 2020-21.

There are three different ways people can be detain - either by emergency certificate, short term detention, or through a compulsory treatment order - and rates rose in each of these. 

Poverty and mental illness

The report examines detentions against the Scottish Index of Multiple Deprivation (SIMD), and finds a higher proportion of detentions of people from the most deprived areas. 

People from the 20% most deprived areas in Scotland accounted for 38.3% of emergency detentions, 32.2% of short term detentions, and 29.6% of compulsory treatment orders.

Julie Paterson, chief executive of the Mental Welfare Commission, said:

“When people become very unwell with mental ill health, some aspects of their care and treatment may need to be delivered against their will, to ensure their safety and wellbeing. All such detentions must be done using the Mental Health Act, should last for the shortest possible length of time, and must be reported to the Mental Welfare Commission.

“We monitor how the law is used. Today’s report shows that once again figures for such detentions have risen, but this time the rise is more than double the average over the previous five years.

“We don’t know why this is, but we are concerned. Every detention is the deprivation of a person’s liberty, albeit for the best possible reason in wishing to treat that individual. 

“The question is whether more people in the population are becoming more seriously unwell every year, with last year’s spike even more pronounced. Or whether services are under such pressure that people wait too long, and only receive care and treatment once they have become so unwell they require to be detained. 

“Whichever is the case, these rising numbers suggest that pressures on mental health services increased significantly last year. 

“We are also very concerned over the way detentions are taking place. Consent of a mental health officer (a specialist social worker) is an important safeguard and should happen every time a person is detained using the Act. For emergency detentions, consent fell below half of all such detentions last year, with big variations in different parts of Scotland. This is unacceptable and unfair to patients, who should all receive the protection of this safeguard, no matter where they live in the country”.

The report shows higher number of detentions for people from ethnic minority groups compared to population levels. Four per cent of Scotland’s population identifies as from an ethnic minority (Asian, African, Caribbean or Black, Other or Mixed).  Proportion of people detained for mental health treatment from these groups were 6% for emergency detentions, 7.4% for short term detentions, and 7.6% for compulsory treatment orders. 

Julie Paterson added:

“This report is not the first to show a link between deprivation and mental ill health, but for the first time we see these inequalities among people detained for mental health care and treatment. 

“We hope that by sharing this information, and our data on ethnicity, geographical variations and other aspects of detention, we can support government and services to ensure they provide the right levels of resource and support for vulnerable communities.

“We also call once again for urgent action to ensure mental health officer consent to emergency detentions.”