The wide-ranging review proposes giving more rights to patients
“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.” Professor Colin McKay, Edinburgh Napier University
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:
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.
This extensive review from John Scott, which recommends far-reaching changes to the law in Scotland, is welcome. Like the proposed new mental health legislation for England and Wales, it calls for a greater focus on patient voice and on patient rights. This reflects a shift in recent years away from outdated paternalistic attitudes to mentally ill people towards a better understanding of their right to autonomy and a say in how they are treated. The mention of digital rights is welcome; however, there is much progress to be made in terms of data use, informed consent and algorithmic handling of vulnerable individuals. We hope the Scottish government will read the report carefully and implement its recommendations. The UK government approach to the 10-year mental health plan has not been updated since consultation in April. This is a critical area and the vague mentions of mental health in Our Plan for Patients will no doubt have left the sector wanting more.