Human Rights Impact Assessment (HRIA): Mental Health and Wellbeing Strategy, Delivery Plan and Workforce Action Plan

Yes

Engaged by the strategy due to implications of suicide; a duty to protect life from risks by self/others.

2.5.4, 4.1, 4.2, 4.3, 4.4, Creating Hope Together

The right to life will be positively impacted by the Strategy. Strategic action 4 is based around continuing to work towards realising the ambitions in the Creating Hope Together Strategy, as separate specific strategy on suicide prevention and distress intervention. As with the Mental Health and Wellbeing Strategy, equalities and human rights underpin the vision and actions throughout. This work should uphold the right to life and have a positive impact, promoting early intervention for people in distress or contemplating suicide.

Yes

The State must not act in a way that that subjects a person to torture or to inhuman or degrading treatment or punishment.

2.4 (2.4.2, 2.4.3, 2.4.4), 4.1.1, 5.1, 6.6, 9.3,

10.3.

Everyone deserves, and should be able to expect, sensitive and humane treatment when accessing mental health support. The Strategy acknowledges that traumatic experiences affect most people at some stage in life and the impact of trauma is unique to each of us. It can negatively impact mental health and wellbeing as well how and when people seek and access support. The National Trauma Transformation Programme was set up to promote a trauma-informed approach using universal principles to help recognise the impact trauma may be having on people seeking support and to work with them and respond in a way that supports recovery. The Strategy has trauma informed and responsive care as a foundation and there are several actions in the Delivery Plan and Workforce Action Plan that will help achieve this. The ambition is that anyone who receives care will do so with a trauma informed, responsive and person-centred approach no matter their previous experiences. This will have a positive impact on human rights.

In regard to detention of a person, there are processes and safeguards in the Mental Health (Care and Treatment) (Scotland) Act 2003 (“the 2003 Act”) designed to ensure that a person is only subject to compulsory care and treatment where this is absolutely necessary. When a person is subject to compulsory care and treatment, there are safeguards in place for the individual. Both the Adults with Incapacity (Scotland) Act 2000 (“the AWI Act”) and the 2003 Act are clear about the need to take into account/ have regard to the wishes and feelings of the adult. The Mental Health and Capacity Reform Programme will consider how best to build on and enhance human rights protections in mental health and capacity law.

Yes

Detention under mental health law

6.6, 9.3

Scottish mental health law is fully compliant with article 5 of the ECHR. Deprivation of liberty on the grounds of mental disorder is permitted under article 5.

In 2019, Scottish Government commissioned an overarching independent review, the ‘Scottish Mental Health Law Review’. This looked at how our mental health, incapacity and adult support and protection laws can be further strengthened from a human rights perspective and how we can remove any barriers to care and support that people might face.

The Review published its final report in September 2022 and provided over 200 proposals for reform. These were based on extensive engagement with a wide range of organisations and people with lived experience on the issues that matter to them. This wider review followed two earlier independent reviews: one into the delivery of forensic mental health services and one which considered how mental health law works for those with learning disability and autism.

The Scottish Government responded to the recommendations in June 2023 and committed to establishing a Mental Health and Capacity Reform Programme. This gives the Scottish Government the opportunity to strengthen how mental health and capacity law interacts with human rights and equalities and seeking related improvements in policy and practice. More information can be found in the Mental Health Law Review.

Yes

Privacy and involving family in care decisions.

Covered in CRWIA

We have engaged significantly with children, young people and their families since 2017 through several functions like the Children and Young People’s Mental Health Taskforce and most recently the Joint Delivery Board on Children and Young People’s mental health. We have heard that children and young people want to advocate for themselves, have a choice about how they access information on mental health and wellbeing and be part of the decision making process regarding their care. Strategic action 2.1 and the actions below this, aim to expand the range of formats that mental health and wellbeing information is available on, including significant work with children and young people on resources for this demographic. All actions relating to children and young people are based around a GIRFEC approach which is wholly rights based, encouraging a person centred, adaptive approach recognising the different needs of individuals

There is an expectation of privacy when using services and organisations have an obligation to protect people’s information, medical records and any data they hold on they to uphold confidentiality. Data breaches are taken seriously in Scottish Government, who are ultimately responsible for public organisations like NHS Scotland.

Yes

Equalities work relevant here. Indirect discrimination is contained under this right as well as direct.

Yes

From engagement and the evidence gathered while developing the Strategy and Plans, we know that discrimination can prevent people from seeking, accessing, and continuing to engage with mental health support. Those who face discrimination are also more likely to have poor mental health. This is one of the key reasons why equalities are embedded throughout the Strategy and Plans. There are specific actions around reducing discrimination and inequalities in both Plans and the Strategy. A specific inequalities action table within the Delivery Plan sets out actions and how they relate to specific protected characteristics.

The mental health evidence review and EQIA set out a significant piece of work around inequalities and discrimination, and how the Strategy, Workforce Action Plan and Delivery Plan address this. EQIA for Delivery Plan. EQIA for Workforce AP. More detail can be found in the inequality Action Table in the Delivery Plan.

Yes

Equalities work will be relevant if any other rights in the covenant are relevant to the work of the mental health and wellbeing strategy.

More detail in the Inequality Action Table in the Delivery Plan (page 51).

Yes

Engaged by the strategy due to implications of suicide; a duty to protect life from risks by self/others.

As in EHCR table article 2 above.

Yes

The State must not act in a way that that subjects a person to torture or to inhuman or degrading treatment or punishment Prevention of ill-treatment, protection and rehabilitation of survivors of ill treatment.

Ensuring trauma responsive services and ensuring access to support for people affected by trauma.

As in EHCR table article 3 above.

Yes

Detention under mental health law.

6.6, 9.3

The 2003 Act sets out clear processes and safeguards for persons detained under mental health law for necessary care and treatment (see Article 3 ECHR above). The Mental Health and Capacity Reform Programme will consider how best to build on and enhance human rights protections in mental health and capacity law..

Yes

Detention under mental health law.

6.6, 9.3

Both the AWI Act and the 2003 Act are clear about the need to take into account/ have regard to the wishes and feelings of people and carers. The Mental Health and Capacity Reform Programme will consider how best to build on and enhance human rights protections in mental health and capacity law.

Yes

Family mental health

4.4 (4.4.1), 5.2 (5.2.1, 5.2.2), 9.1, 10.1 (10.1.1-10.1.5), 10.2 (10.2.1-10.2.3).

Family and perinatal mental health work and work around GIRFEC is relevant to this article.

Yes

Protection of the mental health of children and young people

4.4 (4.4.1), 5.2 (5.2.1, 5.2.2), 9.1, 10.1 (10.1.1-10.1.5), 10.2 (10.2.1-10.2.3).

Packages of work around children and young peoples mental health, perinatal mental health and mental health support in education are relevant to this article.

Yes

If access to public service includes access to NHS services, social work, etc.

All priorities and actions support the right to the right support at the right time and place.

Yes

Mental Health Law and forensic

6.6, 8.1 (8.1.1-8.1.4), 9.3.

The 2003 Act sets out clear processes and safeguards for persons detained under mental health law for necessary care and treatment (see Article 3 ECHR above). The Mental Health and Capacity Reform Programme will consider how best to build on and enhance human rights protections in mental health and capacity law.

Yes

Culturally sensitive services

2.2, 2.3, 2.4, 2.6, 2.7, 3.2, 6.3, 9.2,

10.3.

Culturally sensitive services and staff.

Workforce training for support of equalities groups - Minority ethnic and religious minority (including the need for culturally sensitive services), choice and agency in support received.

Health and Social Care: National Workforce Strategy - Deliver up-to-date, relevant and impactful training for staff around Equality, Diversity and Inclusion; Working with NES to improve mandatory Equality, Diversity and Inclusion training for Health and Social Care staff.

Yes

Relevant as several articles in this covenant are invoked by the Strategy.

Yes, all actions should enhance rights.

Yes

Regarding MH Law.

6.6, 9.3

The 2003 Act sets out clear processes and safeguards for persons detained under mental health law for necessary care and treatment (see Article 3 ECHR above). The Mental Health and Capacity Reform Programme will consider how best to build on and enhance human rights protections in mental health and capacity law.

Yes

Right to healthy working conditions incorporates mental health – therefore this is relevant to the strategy.

2.5 (2.5.1-2.5.5).

We will continue to promote the Healthy Working Lives’ mental health and wellbeing digital platform to help employers in Scotland actively support and promote mental health at work. The platform signposts employers to a wide range of mental health and wellbeing resources. These include information and advice on understanding mental health, mental health and the law and staff learning and development opportunities, as well as signposting to sources of support.

Yes

This right includes – protection and assistance for families; special protection for mothers during a reasonable period before and after childbirth; protection and assistance on behalf of all children and young people. This includes protecting them from economic and social exploitation that may negatively impact their health.

Work to support CYP mental health, and perinatal mental health is relevant.

As above in article 23 and 24 of ICCPR.

Yes

Entire Strategy and all actions.

Yes

The entire Strategy and all actions, specifically equality and disability focused actions, will help to uphold these rights. The specific themes and actions in the Inequality Action Table that support these rights are – Social determinants of mental health; poverty and deprivation (2.4, 4.4, 5.1, 5.2); experiences of minority stress, discrimination and trauma (2.7, 4.4, 5.1, 9.1,10.3). Accessing services; lack of targeted information and lack of inclusive communication (2.1, 2.2, 2.3, 2.6, 2.7, 4.4,9.1, 9.2); diagnostic overshadowing (2.7, 4.5, 7.1, 9.1, 9.2, 10.4). Experience of using services; choice and agency in support received (2.2, 2.3, 2.6, 3.2, 6.3, 9.2, 10.3). Data and evidence gaps; lack of disaggregated data (6.4, 6.5). Tackling a range of inequalities (3.1, 3.2, 4.1, 4.2, 4.4, 6.1, 6.2, 6.6, 7.1, 8.1, 9.3, 10.4).

Yes

Yes

.

Yes

Equalities work will take into account people who are subject to multiple discrimination.

Yes

Take all action to ensure children with disabilities enjoy all human rights.

Yes

Raise awareness of disabilities, and foster respect for the rights and dignity of disabled people. Combat stereotypes, prejudices and harmful practices. Promote awareness of the capabilities and contributions of persons with disabilities.

Yes

Ensure accessibility in all aspects of life for disabled people, this will include measures taken to ensure accessible mental health services for disabled people.

Scottish Government will work with NHS Boards to ensure the mental health built estate enables the delivery of high quality, person centred and safe care. In doing so, we will take into account the findings from Equalities Impact Assessments and other relevant assessments.(7.2)

Yes

Engaged by the strategy due to implications of suicide; a duty to protect life from risks by self/others.

As EHCR table above, article 2.

Yes

Equality under mental health law.

As Mental Health Law (EHCR article 3; article 5. ICCPR article 9) and trauma (EHCR article 3) related actions described above.

Yes

Detention under mental health law.

Yes

The State must not act in a way that that subjects a person to torture or to inhuman or degrading treatment or punishment Prevention of ill-treatment, protection and rehabilitation of survivors of ill treatment

Ensuring trauma responsive services, and ensuring access to support for people affected by trauma.

Yes

States Parties shall take all appropriate measures to promote the physical, cognitive and psychological recovery, rehabilitation and social reintegration of persons with disabilities who become victims of any form of exploitation, violence or abuse, including through the provision of protection services

Yes

Right to respect for the physical and mental integrity of disabled people on an equal basis with others

As all of the equalities work described above.

Yes

Community services and facilities for the general population are available on an equal basis to persons with disabilities and are responsive to their needs.

Yes

Need to ensure accessible information on mental health, mental wellbeing and mental health services for disabled people.

Yes

States Parties recognize that persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability.

Yes

The Strategy includes work on improving data collected around mental health. Specific actions include; Data and evidence gaps; lack of disaggregated data (6.4, 6.5); lack of quantitative and qualitative data (4.2, 6.4, 6.5). Tackling a range of inequalities (3.1, 3.2, 4.1, 4.2, 4.4, 6.1, 6.2, 6.6, 7.1, 8.1, 9.3, 10.4).

Yes

The Delivery Plan and Workforce Action Plan cover this Convention with all actions, specifically the equalities work. The work focused on women is highlighted in the Inequality Action Table in the Delivery Plan and includes the themes - social determinants of health; poverty and deprivation (strategic actions 2.4, 4.4, 5.1, 5.2); experiences of minority stress, discrimination and trauma (strategic actions 2.7, 4.4, 5.1, 9.1, 10.3); loneliness and isolation (strategic actions 3.2, 10.2); diagnostic overshadowing (strategic actions 2.7, 4.5, 7.1, 9.1, 9.2, 10.4). Experience of using services; workforce training (strategic actions 2.3, 2.4, 2.7); choice and agency in support received (strategic actions 2.2, 2.3, 2.6, 3.2, 6.3, 9.2, 10.3). Tackling a range of inequalities (strategic actions 3.1, 3.2, 4.1, 4.2, 4.4, 6.1, 6.2, 6.6, 7.1, 8.1, 9.3, 10.4).

The Women’s Health Plan, published in August 2021 aims to address health inequalities and improve health outcomes for women and girls. There are actions being delivered through the plan which are of relevance to the mental health and wellbeing workforce. This includes promoting the menopause and menstrual health workplace policy that is being developed for NHS Scotland Staff. We will promote use of this best practice example for all employers within the mental health and wellbeing system and encourage equivalent efforts. This will be supported by inviting a representative from the mental health and wellbeing workforce to participate in the Menopause and Menstrual Health Working Group which will consider the implementation of the workplace policy for NHS Scotland as an example of best practice.

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Equalities work to eliminate mental health inequalities based on race are relevant here.

The Delivery Plan and Workforce Action Plan cover this Convention with all actions, specifically the equalities work. The work focused on women is highlighted in the Inequality Action Table in the Delivery Plan and includes the themes – social determinants of health; poverty and deprivation (strategic actions 2.4, 4.4, 5.1, 5.2); experiences of minority stress, discrimination and trauma (2.7, 4.4, 5.1, 9.1, 10.3). Accessing Services; mental health stigma (1.1, 2.3, 2.5, 2.7, 9.1, 10.4); lack of targeted information and lack of inclusive communication (2.1, 2.2, 2.3, 2.6, 2.7, 4.4, 9.1, 9.2). Experience of using services; workforce training for support of equalities groups (2.3, 2.4, 2.7); workforce diversity (2.3); choice and agency in support received (2.2, 2.3, 2.6, 3.2, 6.3, 9.2, 10.3). Data and evidence gaps; lack of disaggregated data (6.4, 6.5); lack of quantitative and qualitative data (4.2, 6.4, 6.5). Tackling a range of inequalities (3.1, 3.2, 4.1, 4.2, 4.4, 6.1, 6.2, 6.6, 7.1, 8.1, 9.3, 10.4).Workforce - The new Anti-Racist Employment strategy gives employers practical guidance and support in addressing racial inequality in the workplace. This strategy provides resources for employers, and it will be promoted as part of the Action Plan to mental and wellbeing workforce employers.

Yes

• Right to work, free choice of employment and favourable working conditions
• Right to public health, medical care, social security and social services

Yes

Workforce training

Yes

This extends to training being provided to any person who may be involved in the custody, interrogation, or treatment of any individual subjected to any form of arrest, detention, or imprisonment. Relevant to the mental health and wellbeing workforce.

The workforce actions aim to achieve a workforce which are supported to provide effective, person-centred, trauma- informed, rights based compassionate services and support .

Yes

If rehabilitation includes mental health services.

Trauma informed practice as in EHCR above – DP actions 2.4 (2.4.2, 2.4.3, 2.4.4), 4.1.1, 5.1, 6.6, 9.3, 10.3.

Yes

The State must not act in a way that that subjects a person to torture or to inhuman or degrading treatment or punishment.

Prevention of ill-treatment, protection and rehabilitation of survivors of ill treatment.

to support for people affected by trauma.

Trauma informed practice as in EHCR above – DP actions 2.4 (2.4.2, 2.4.3, 2.4.4), 4.1.1, 5.1, 6.6, 9.3, 10.3.

Mental Health Law as in ICCPR articles 9 and 10.