The RCPsych in Scotland has published its response to the Scott Review into Mental Health Law, the most extensive policy consultation response the College in Scotland has attempted. This included:
- We issued a call for evidence to all of our 1,400 members for written responses.
- This is supplemented by 7 workshops covering each of the chapters, with over 120 participants in these discussions. These participants represented wider collective groups by specialty, setting and geography.
- Our range of participants extended to lived experience representatives and across the different clinical specialisms of our membership.
The response extended to 30,000 words covering 93 of the 96 questions, with a seperate overarching summary developed with the endorsement of the Scottish Academy of ROyal Medical Colleges. Our key positions include:
- Scope – The proposals extend far beyond the core purpose of mental health legislation, and its initially intended beneficiaries of those with a mental health condition. We endorse the position of the Review that some provisions will need to be in laws which apply to everyone. We would advocate that a focussed set of instruments in the context of the provision of mental health care would allow the promotion of rights for those who are amongst the most disadvantaged in society.
- Inclusion – Any new legislation, and its proposals, must work for all people of all ages, including children and young people and people with learning disabilities. We recognise this may be difficult for the forensic population, but this should apply to this population to the greatest possible extent.
- Workforce implications – We urge that specific evaluations of the workforce and resource implications of proposals from the Review are undertaken ahead of any legislative process, across all relevant settings. Identification and resourcing for additional requirements is essential to ensure we have a workforce able to mee the needs of people with mental health conditions and to minimise where possible the need for compulsory and/or restrictive practices.
- Clinical diagnosis – While recognising the need to address stigma and reduce it around mental health conditions, removing the criterion within legislation of a mental health diagnosis or condition is not the way forward. The use of diagnostic criteria allows a link to be made between a condition, its effects, potential interventions, and the use of legal frameworks to provide said interventions. It allows an approach based on objective evidence which can then be effectively challenged, thereby improving the protection of rights.
- Children and young people – There are significant concerns around the need to consider children and young people across the proposals, and to avoid pursuing twin-track children’s legislation. We do not believe this would deliver the protections and safeguards available to children and young people under current legislation.