30 August 2017
The Mental Welfare Commission today published
its first Scotland-wide report on medium and low security forensic
The report has positive findings related to staff and to patient
care, but it highlights concerns over delays in patients moving on
from medium and low security wards.
The Commission visited all 46 wards across the country - 14 of
which are for medium secure patients, the remainder being low
secure - and reviewed the care of 165 patients.
The report found that risk assessment, care planning, and access
to advocacy was good. Most patients spoke well of their care and
treatment, and of the staff who cared for them.
However, the Commission also found that there were patients in
Scotland's medium secure units who had successfully appealed
against the level of security in which they were held and were
waiting to move on, but there were frustrations at the length of
time this takes.
Sixty one patients in 24 of the wards in low security units were
also waiting to move on, either to a rehabilitation bed or to a
The report identified variations across the country in the use
of restrictions for patients, with no clear reason as to why some
wards kept this to a minimum, whilst others did not.
One in five patients said they felt unsafe, or partially unsafe,
at times in the ward.
Alison Thomson, Executive Director (Nursing) at the Mental
Welfare Commission said:
"Many of our findings are good, including positive
comments from patients about the staff who care for them, and good
access to advocacy and psychological services. This is welcome.
"But we were concerned about the human rights of patients who
are being held in conditions of excessive security due to a lack of
suitable places to move on to. We found that even after they have
successfully won appeals at a Mental Health Tribunal, some medium
secure patients were waiting to move on for longer than need
"In turn, low secure units were often finding it difficult to
take these patients, as they themselves were having difficulty
finding suitable places in the community for people ready to
"This backlog in moving people to the least restrictive
situation must be addressed."
The full report contains recommendations for the Scottish
Government, Health Boards/Integrated Joint Boards and the Scottish
Patient Safety Programme Mental Health.
A copy of the report is available here.
Note to editors
- All patients in Scotland's three medium secure units -
Rowanbank Clinic in Glasgow, the Orchard Clinic in Edinburgh, and
Rohallion Clinic in Perth - are detained in hospital under
- All of the patients we visited in low security wards were
detained under legislation. On our visits we found that almost half
of those patients were there due to detention under the Mental
Health Act, and not criminal courts. Some will not have an
offending history. The report refers to this issue.
- Since 2006, patients in the State Hospital - Scotland's only
high security forensic hospital - have been able to contest their
level of security with the Mental Health Tribunal. In November
2015, this option was extended to patients in Scotland's three
medium secure units. We wanted to see if this change in legislation
was having an effect on services. The report found (page 50) that
successful appeals were putting pressure on services.
- This report focused on medium and low secure units only, as the
Commission visits the State Hospital twice a year, and reports
separately on these visits.
Mary Mowat: 0131 313 8786