Scotland’s mental health laws should be overhauled, review says

Scotland needs to overhaul its mental health legislation to strengthen the voice of patients and focus more on their human rights, according to an independent review.

The Scottish Mental Health Law Review, led by John Scott KC, made more than 200 recommendations, including giving more powers to the Mental Welfare Commission. It was commissioned by the Scottish government in March 2019 in response to a petition that highlighted developments both in care and treatment and international human rights law. Existing mental health laws in Scotland were passed in 2003.

Professor Colin McKay of Edinburgh Napier University, who was an executive member of the 900-page review, said the law needed to be strengthened in three main areas:

• Giving a stronger voice to patients using mental health services, including those with a learning disability or who have conditions such as dementia. Patients, said McKay, “need more say in their care and treatment and in what happens to them.”
• Reducing restrictive or coercive practices, such as the use of restraint and seclusion.
• Introducing “positive rights”. These included the right to “the maximum attainable health” and the right to “independent living.”

People in crisis unable to access support

McKay told the BBC that, while there were some good services, the review had heard “distressing stories” from people who experienced a mental health crisis but were unable to access the support they needed.

He added: “When the laws changed in 2003, we were probably in the forefront of rights respecting mental health law. If we want to maintain that position, if we want to be seen as a beacon, as an exemplar of human rights, we need to change again.”

The review also said there was an urgent need to reform services for children and young people experiencing acute mental distress.

Scott, who chaired the review, said the recommendations would bring Scotland into line with thinking and practice internationally. He said it would take some time to implement the recommendations fully, however, but that culture change could begin immediately. He said: “Some recommendations will depend on greater resources and an increase in the number of mental health practitioners. Co-ordination will be required within government to address some areas that cut across different departments. This will not be easy but is consistent with the developing picture in Scotland of human rights for everyone which should be clarified in the Scottish government’s forthcoming Human Rights Bill.”

Julie Paterson, chief executive of the Mental Welfare Commission, said the report offered “a major opportunity to get it right for the future.”

The Scottish government said it would take time to consider the recommendations in the report.