Mental health strategy 2017-2027: second progress report

7. Rights and Mental Health

The Mental Health Strategy recognises the importance of taking a human-rights based approach to the delivery of each of the Actions. This seeks to ensure that people are empowered to both know and claim their rights, and to increase the ability and accountability of those responsible for fulfilling, protecting and respecting them. For example, our mental health law is based on rights and principles, and offers safeguards for patients where compulsory treatment is necessary. This section shows how the Scottish Government is re-affirming its commitment to human rights, in particular, through review of Strategy’s equality impact assessment and various reviews of the mental health legislative framework.

Assessing equality and human rights impacts

The Mental Health Strategy makes it clear that its vision and ambitions apply to all citizens of Scotland. Our human rights approach means that we will seek to address stigma and discrimination in all its forms, and remove barriers that prevent people with a mental illness from reaching their full potential.

In early 2020, we will be working with advocates for protected characteristics groups to review the equality impact assessment (EQIA) for the strategy. This will not only be an opportunity to consider the use and interpretation of the available evidence and data, but also a catalyst for improving links between organisations and individuals advocating for protected characteristic groups and Scottish Government officials as well as how we reach ‘hidden populations’ of service users. We will work with colleagues from the Scottish Government human rights team to ensure that we are fully considering the impact of human rights and taking appropriate action to ensure that individuals’ rights are fulfilled.

Building on Success: Independent Review of Mental Health Legislation in Scotland

This year, the Scottish Government announced an independent review of the Mental Health Act, chaired by John Scott QC, reaffirming our commitment to a modern, inclusive Scotland which protects and respects human rights.

Building on the work carried out under Actions 33 and 34, this over-arching review aims to improve the rights and protections of those living with mental illness and remove barriers to those caring for their health and welfare. It will examine developments in mental health law and practice concerning compulsion as well as care and treatment since the current legislation came into force in 2005.

We are clear that the views of patients, those with lived experience and those that care for them will be front and centre of the work, so that they can help shape the future direction of our legislation.

Mental health and incapacity legislation and practice (Actions 32, 33, 34 and 35)

Action 32 is being progressed through the revision of the statutory Code of Practice for the Mental Health (Care and Treatment) (Scotland) Act 2003 to better incorporate and reflect a rights-based approach for practitioners. Alongside the legislative updates required to the Code, over the course of the year there has been extensive stakeholder engagement to identify key practice issues requiring update or clarification within the new version. The wider issue of whether current mental health legislation fulfils the needs of people with learning disability and people with autism is considered in Action 33. The independent review team have gathered evidence on how people with learning disability or people with autism experience the Mental Health (Care and Treatment) (Scotland) Act 2003 and will make recommendations concerning any future reforms, if they think they would help better support people’s human rights. The review has taken a human rights-based approach which places a strong emphasis on consulting with, and actively involving, people in its work. For example, all advisory groups consist of professionals and people with lived experience. The final public engagement phase commenced on 30 August 2019 and the review will report its findings in December 2019.

The reform of legislation for Adults with Incapacity (Action 34), continues on a revised timescale. This work will now be carried out alongside other strands of the recently announced Review of Mental Health Legislation. As such, the timetable for putting this before parliament has changed to align with that of the wider review (it had been due in Spring 2019). We will develop guidance on power of attorney and improved risk assessment of supervision of guardians by December 2019. The Review will produce an Interim Report in May 2020 which will identify priorities and an overall timeline for the next stage of the review, based on the evidence it has gathered.

Action 35 recognises the invaluable contribution made by the Mental Health Officer (MHO) workforce in improving the lives of people with mental health problems, their friends and families and acknowledges the pressures being experienced by the workforce. While it is the responsibility of Local Authorities to plan their MHO workforce, ensuring they have the appropriate levels of staff in place to provide services for their residents, we have engaged with relevant stakeholders and are developing proposals to better support MHO capacity. This will include specific proposals to provide MHOs with capacity, experience and skills for the most vulnerable groups – for example, children and young people and those with a learning disability. These proposals are being progressed in partnership with COSLA.

Employment (Actions 36 and 37) 

We know the mental health benefits of working in mentally healthy workplaces. Along with See Me’s targeted work programme, NHS Health Scotland continues to lead on activities to support employers and employees through its Work Positive and Healthy Working Lives Programmes and in partnership with public and private sector employers, is developing a framework of key standards that will demonstrate how employers are supporting a mentally flourishing workplace. Also, in recognition of the importance the Scottish Government places on staff wellbeing and resilience, particularly for those who are called upon to offer assistance in moments of crisis and trauma, we are providing funding of £138,000 to extend the Lifelines Scotland wellbeing programme to cover emergency responders in Police, Ambulance and Fire Services. 

As part of our commitment to achieve a coordinated and aligned employability and health pathway for those with mental health problems, given in “A Fairer Scotland for Disabled People: Employment Action Plan” Scottish Government will evaluate the employment support provided to those who suffer mental ill-health and make improvement to Fair Start Scotland, which will include reviewing how individual placement and support is delivered within Scotland.