Human rights concerns over rise in emergency detentions made under Mental Health Act

Human rights concerns have been raised after new figures showed a rise in the use of compulsory powers under the Mental Health Act.

Mental Welfare Commission data shows there were 5,008 new episodes of compulsory treatment in 2015/16, up 3% on the previous year and the highest level since the Act was implemented in 2005.

The biggest rise (10%) was in emergency detention certificates, used in crisis situations to detain a person who needs urgent care or treatment for mental ill health.

The certificates, which allow someone to be kept in hospital for up to 72 hours, can be issued by any doctor but the Act stipulates there should also be consent from a specialist mental health officer where possible.

Despite this, nearly half (44%) of emergency detentions did not have such consent when the decision was made.

Dr Gary Morrison, medical executive director at the commission, said: “People who are very unwell and need compulsory treatment for their mental ill health are at their most vulnerable.

“A mental health officer can help explain the process, and can also look at alternative ways of supporting a person without needing compulsory treatment. If there is no mental health officer involved in this critical decision, some people may be detained unnecessarily.

“Others may find the experience of being told they will be detained much more traumatic than they would have done if a mental health officer had been there.

“The commission’s role is to protect and promote the human rights of people with mental health problems, so we take this issue seriously.”

The commission said it would be following up on previously published recommendations for government, councils and health boards aimed at driving up the level of mental health officer consent.

It highlighted progress in other areas, including an increase in the number of people treated in the community and a large drop in the use of police stations as a “place of safety” when people who are mentally unwell are removed by officers from a public place.

In a separate report, the commission found a rise in the use of provisions under the Adults with Incapacity Act to safeguard people who lack the capacity to make their own decisions.

The number of new welfare guardianship applications granted rose by 8% to 2,657 in 2015/16. While the majority of guardians are relatives, carers or friends, councils have a duty to apply in cases where no-one else has done so.

The highest proportion of welfare guardianships were sought for people who had dementia (45%) or a learning disability (41%).

Mike Diamond, the commission’s executive director of social work, said: “The continued steep rise in guardianship applications is concerning. Most relatives find guardianship helpful, but it is a complex legal process and takes up a considerable amount of time for care professionals, particularly mental health officers.

“We believe the law needs to be modernised and streamlined to ensure care can be provided when it is needed, and to better protect the rights of people with dementia and learning disabilities. We welcome the commitment of the Scottish Government in their draft mental health strategy to a review of the law, and we hope to see early progress.”

Maureen Watt, Minister for Mental Health, said: “These figures should be seen against a backdrop of rising demand for mental health services, and a greater awareness of mental health issues leading to more people coming forward and asking for help.

“It should also be remembered that, in certain circumstances, compulsory treatment is essential to provide protection to the patient and others. Where compulsory treatment is used, the rights of patients are safeguarded by legislation. Safeguards include a right to independent advocacy, and an efficient Mental Health Tribunal system which grants and reviews orders for compulsory treatment.

“The rise in compulsory treatments may be due to increased diligence from professionals in using the legislation appropriately. However, we will continue to work with the Mental Welfare Commission and stakeholders both to ensure these orders are used correctly, and to promote patients’ rights more generally. Indeed, patient rights will be a key part of our new Mental Health Strategy, which will be published at the end of the year and backed with £150 million of funding over five years.”

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