Independent Review into the Delivery of Forensic Mental Health Services: Scottish Government response

Ministerial Foreword

In March 2019, the former Minister for Mental Health, Clare Haughey, commissioned an independent review into the delivery of forensic mental health services chaired by Derek Barron, Director of Care at Erskine.

I want to take this opportunity to thank Derek Barron and his team for their hard work, dedication and resilience in bringing the final report together during a global pandemic.

Patients in the forensic mental health system are among the most marginalised people in our society. Forensic mental health services are highly specialised and assess, treat and risk manage people with significant complex needs. Services must be designed to provide readily accessible, high quality clinical care in Scotland within a level of security that is the least restrictive alternative whilst keeping our wider communities (including those who provide this care) safe.

Over the past decade, there has been a shift in emphasis: the number of patients being treated at the State Hospital has been in decline, medium secure services are provided in the North, West and East of the country, and there have been developments in low secure and community service provision. The review has been an opportunity to recognise the work of these services, understand the issues across the whole system, and take a strategic view to improve our services for patients, families, carers, staff and the public.

I very much welcome that the review took a rights based approach. The Millan Principles - which underpin mental health legislation in Scotland - are throughout the recommendations of the review and equality is at the forefront of recommendations about service change.

It is right that the review focussed on low secure and community services. These are provided and managed locally and whilst they are a very small part of any large Health Board or Health and Social Care Partnership, they are crucial to the system of forensic mental health care.

The recommendations emphasise participation of service users and respect for carers. The Scottish Government considers these to be important not only in service provision but in service improvement and reform. I would like to take this opportunity to express my thanks to all those who met with the review team or who contributed, especially those with lived experience, their families and carers.

The Scottish Government welcomes the Independent Review final report and its recommendations. The report is thoughtful, considered and provides a good basis for collaborative working that can bring forensic mental health services together in a way that works for patients, families, carers, clinicians and the public.