There were 5,008 new episodes of compulsory treatment for mental ill health in Scotland last year – the highest level since the 2003 Mental Health Act was introduced, new figures have revealed.
However, 44% of emergency detentions initiated by a doctor did not have the support and expertise of a mental health officer at the point when that decision was made. This aspect of the data raises concerns in the Commission about patients' human rights.
The new data was released by the Mental Welfare Commission, in its annual monitoring report examining national and regional use of the law in treating people for mental ill health.
Other data, particularly the declining use of police stations as places of safety, was more positive.
There are three forms of certification for compulsory treatment, and the most marked rise was in the use of emergency detention certificates, which are used in crisis situations to detain a person who needs urgent care or treatment for mental ill health.
These certificates can be issued by any doctor, and allow someone to be kept in hospital for up to 72 hours.
The Mental Health Act says that there should be consent from a specialist social worker – known as a mental health officer – wherever practicable when these certificates are used. But while there was a 10% rise in the use of these certificates last year, only 56% of the total had the consent of a mental health officer.
Dr Gary Morrison, executive director (medical) at the Mental Welfare Commission, said: "People who are very unwell, and need compulsory treatment for their mental ill health, are at their most vulnerable.
“A mental health officer can help explain the process, and can also look at alternative ways of supporting a person without needing compulsory treatment. If there is no mental health officer involved in this critical decision, some people may be detained unnecessarily.
“Others may find the experience of being told they will be detained much more traumatic than they would have done if a mental health officer had been there.
“The Commission's role is to protect and promote the human rights of people with mental health problems, so we take this issue seriously. There are significant variations across the country, and we expect those areas with low levels of mental health officer involvement to develop clear action plans for improvement.”
Last year the Scottish Government asked the Commission to examine the reasons for low levels of mental health officer consent. In June 2016, the Commission published an audit which made recommendations for action by Scottish Government, local authorities and NHS Boards.
Following the publication of figures for the full year, the Commission will be following up these recommendations with the bodies concerned.
Increasing treatment in the community
Another significant finding in the report is that the number of people treated through community-based Compulsory Treatment Orders (CTOs) has risen to 40% in the past year. In 2006, only 4% were treated through CTOs.
“We support treatment in the community wherever possible, and believe that community based Compulsory Treatment Orders have a valuable role to play,” said Dr Morrison. “However, our recent report on the use of these orders highlighted that more needs to be done to help people plan for a future without the need for compulsory care.”
Elsewhere, while there was a rise in the number of people detained by police to a 'place of safety' – those who are mentally unwell being removed from a public place by the police – the number who were detained in a police station has fallen significantly.
Four years ago there were 591 such incidents and 18% of those detained were in a police station. But while last year there were 795 incidents, only 1% were detained in a police station.