Short Life Mental Health Legislation Commencement Consideration Group minutes: December 2020

Welcome and introductions

The Chair welcomed attendees to the twelfth meeting of the Group.

• Minutes of the 11th meeting which took place on 10 November.

2. Update on Reporting & Scrutiny

The Group were updated on the latest activity in relation to parliamentary scrutiny and reporting on the coronavirus legislation.  The 4th report to the Scottish Parliament on the legislative measures is due to be published on 9 December.

3. Consideration of evidence for commencement of temporary amendments within the UK Coronavirus Act 2020

The Chair then turned to the main item on the agenda, the consideration of evidence and intelligence on how the mental health system is operating under current circumstances.

There was a general discussion regarding the trend in activity and the following points were noted in discussion:

• The Mental Health Tribunal reported that overall they have a reasonably stable operation and are presently able to manage workloads.  They are though currently undertaking a recruitment exercise in order to minimise and mitigate any potential disruption to their day to day operations.  Whilst the majority of hearings are still being held virtually they are, and have been able to provide face to face hearings as and when required.
• Their data showed that the average number of weekly applications has risen to 104 as oppose to the 89 applications that had been reported at the last meeting.  Once again this shows considerable fluctuation from week to week and demonstrates the need to be wary of drawing conclusions about the challenges the pandemic continues to pose.
• The Mental Welfare Commission are clear that there now needs to be a focus on  remobilisation however it is likely that some areas will have differing challenges in  order to re-establish appropriate levels of services.
• The data again shows a pattern of use of EDC’s against the numbers of STDC’s however the MWC are now looking to see how the Act has worked during this time.  For example, while the levels of MHO consent for EDC’s has reduced this is variable between Heath Boards. Another area for consideration is the DMP safeguard and although the MWC moved to a virtual model to keep this safeguard available they are looking to see what effect this has had.  It’s worth noting that the number of requests for DMP has fallen by 10 - 15 % despite CTO numbers increasing.  There is no obvious reason for this however they plan to investigate further and also advised the group that they envisage a sharp rise in requests for DMP’s moving forward.  In addition they plan to move towards reintroducing face to face consultations although this will have to take a tiered approach to match lockdown restrictions.
• They also reported that there is potential for an increase demand in other areas of work which may have been more subdued as the restrictions caused by the pandemic have required peoples ways of working to be adapted. Overall though they see no evidence to suggest triggering provisions but still seeing there is necessity to keep them on the books.
• Social Work Scotland information shows that there continues to be a steady stream in the number of short term detentions taking place under mental health legislation and also a rise in those moving to CTO’s.  There remains pressures on MHO availability which in turn leaves services vulnerable should there be another spike in activity over the coming winter months.  At a local level then there is a watching brief on the potential for a rise in the need for warrants regarding vulnerable people.  They are in agreement with the data from the MWC when it comes to lack of MHO consent for EDC’s which appears to be most prevalent “out of hours” however this may also be more likely to happen via the more general medical services such as local GP’s or the ER.
• The Royal College of Psychiatrists report that they remain extremely busy and intelligence shows that there are some areas experiencing more difficulties than others.  They commented that while the news regarding the roll out of vaccinations was very welcome they urged a word of caution as it will still take time to implement and therefore the pressure on the workforce as a whole are likely to remain in place for the foreseeable future.

The Group noted that the pandemic remains very challenging and acknowledged that we are moving towards winter, however the current levels of operation of the AWI and Mental Health Acts merits a continued cautious approach in respect of the emergency provisions.  They therefore recommend that those provisions contained within Schedule 9 of the UK Act continue to be retained, but not commenced.

4.  The next meeting will take place in January 2021.

Mental Health and Incapacity Law Unit

December 2020

Attendees and apologies

• Arun Chopra, MWC
• Laura Dunlop, Mental Health Tribunal Scotland
• Bob Leslie, Social Work Scotland
• John Crichton, Royal College of Psychiatrists
• Martin McKenna, SCTS
• Hugh McAloon, SG (Chair)
• Ruth Wilson, SG