We carry out our statutory duties by focussing on five main areas of work. They are visiting people, monitoring the Acts, investigations, information and advice, and influencing and challenging.
This section has information about the main activities we carry out in order to fulfil this role.
Watch this short film made for the Commission's 60th annversary, and read more below.
The Chair and members of the Board are appointed by Scottish Ministers in line with the Commissioner for Public Appointments in Scotland's Code of Practice.
They bring a wealth of experience and knowledge to the Commission, in using and managing mental health and learning disability services.
The Board sets the strategic direction for the Commission and ensures efficient, effective, and accountable governance.
Sandy Riddell trained in social work and has held director level posts in social work, housing, education, and health and social care, including his final role before retirement as Fife’s director of health and social care. Sandy has substantial experience at a national level in shaping policy and legislation in adult health and social care, children’s services, substance misuse, and justice services. He was president of the former Association of Directors of Social Work and founded Social Work Scotland, and has been a member of the Mental Welfare Commission since 2017 before his appointment as chair in April 2019. He is a member of Grampian NHS Board. Sandy is passionate about the need to develop a rights-based approach for services and to fully involve the public in service design and delivery.
Nichola Brown (co-chair of the Advisory Committee) joined the Board in April 2019, as carer representative and is also a designated joint Stakeholder Engagement Champion. She cares for her son who has severe learning disability and complex needs, and brings experience of the challenges for families of navigating services. She has a background in community development having worked in Public Health within Glasgow for twenty five years leading a portfolio of work programmes to improve population health, with particular focus on reducing health inequalities.
Nichola left Glasgow in December 2022 to take up the role of CEO of the North Lanarkshire community organisation, PlayPeace. The service offers play sessions and outings to support families of children with additional needs during school holiday periods. It continues to grow and develop its services, driven by families and the children and young people engaged.
David Hall spent over 25 years as a consultant Psychiatrist and Medical Manager in Dumfries and Galloway, and during that time led the redesign of the local Mental Health service, culminating in the development of a new Mental Health facility at Midpark Hospital.
He has held a number of national roles including National Clinical Lead for the Mental Health Collaborative, and for almost 10 years till, 2019, as National Clinical Lead for the Scottish Patient Safety Programme. He has gained an international reputation in Quality Improvement in Mental Health, and has worked with the Danish and New Zealand governments.
He has also held a number of roles with the Royal College of Psychiatrists, and is currently the RCPsych in Scotland Suicide Prevention Lead, and sits on the National Suicide Prevention Leadership Group.
Kathy Henwood joined the Board in 2023. She has 35 years’ experience in social work, working across local authorities and the third sector, in Scotland and England. Kathy has predominantly worked with children and families, though started her career working in mental health services and in residential care with older people. She has worked across child protection committees, been a guardian ad litem and an associate assessor in inspections as part of the Child Protection Reform programme. She has also been an associate lecturer for the Open University for over 15 years, teaching courses around leadership and management across health and social care. Kathy is Service Director, Children’s Services and Justice Services with Edinburgh City.
Gordon Johnston (vice chair of the Board) has a background in community development, urban regeneration, project development and management, and managing major funding streams. He is currently an independent consultant in mental health, specialising in peer research, user/ patient involvement, policy development and organisational development. Gordon is involved in many third sector organisations and is currently chair of Bipolar Scotland and a director of Voices of experience (VOX). He has also been a member of the delivery group of the Scottish Patient Safety Programme: Mental Health since its inception. Gordon was also appointed as a non-executive Board member and Whistleblowing Champion of NHS Forth Valley by the Cabinet Secretary for Health in February 2020. He is a Steering Group member of the UKRI funded Closing The Gap Network and a member of the Scottish Government’s Mental Health Strategic Delivery Board and Mental Health Research Advisory Group.
Cindy Mackie (wellbeing champion) is an independent consultant with occupational experience in the public, private, and voluntary sectors and currently performs a number of Associate roles within the area of regulation. She is a tribunal member with the Medical Practitioner Tribunal Service, where she is engaged in a decision making role in Fitness to Practise proceedings, she has also served in this capacity with the Nursing and Midwifery Council and the Health and Social Care Council. She is a lay examiner in membership examinations for the Royal College of Obstetricians and Gynaecologists, and is engaged in a chairing role in quality assurance/ educational standards inspections across the UK with the General Dental Council. She holds a position of Independent Assessor in Public Appointments and is also involved in school governance in a voluntary capacity. Cindy brings knowledge of health regulation, public protection, safeguarding, and human rights. She is educated to graduate level with additional qualifications in human resource management and learning and development.
Mary Twaddle (co-chair of the Advisory Committee) has lived experience of mental ill health and recovery and has been treated and supported by general adult mental health services for over 15 years. She is also a designated joint Stakeholder Engagement Champion. Originally studying for degrees in Physics at university, and after time out to focus on her health, she joined NHS Lothian at the end of 2015 as a peer support worker at the medium secure forensic unit, The Orchard Clinic; where she helped build the first peer support service within a medium secure forensic unit in the UK. In her role she uses her own lived experience to help others in their recovery from life changing periods of mental ill health. As part of the multi-disciplinary team she helps maintain the recovery focused ethos of the clinic within the complexities of working in a forensic setting.
Alison White joined the Board in October 2019. She qualified as a Social Worker from Robert Gordon University 20 years ago. Alison was Head of Adult Services and Chief Social Work Officer for Midlothian Health and Social Care Partnership before taking up the role of Chief Officer of the West Lothian Integration Joint Board in July 2021. Alison is passionate about developing person centred, human rights based services.
The teams who do the day-to-day work of the Commission and are the first point of contact for the public.
The executive team carries out the strategic leadership and management of the Commission.
Julie Paterson - chief executive
Julie Paterson was appointed chief executive of the Mental Welfare Commission for Scotland in August 2020. Julie’s first degree was in psychology before completing her Masters in social work. Julie qualified as a mental health officer in 1997 and worked across a range of operational and managerial roles within the social work service prior to becoming head of Adult Social Work Services and designated Chief Social Work Officer. Prior to joining the Commission she had been a senior manager in health and social care for five years retaining responsibility for adult social work services and also leadership and transformation across a diverse range of health services including NHS children’s services, health promotion, mental health, learning disability, psychology and addiction services.
Ashley Dee - head of culture and corporate services
Ashley’s background is in law and his experience spans leadership and governance roles. He’s an experienced solicitor, dual qualified in both the England & Wales and Scotland jurisdictions, and has worked for a large law firm, a UK government inquiry and the SSSC. He has 11 years’ experience at an international medical defence organisation progressing into leadership roles where he managed large multi-disciplinary teams. Whilst there, Ashley acquired significant strategic change experience and - more latterly – led a governance function responsible for managing global third party supplier risk and performance.
Julie O'Neill - business change and improvement manager
Julie joined the Commission in December 2021 as our new business change & improvement manager from the NHS where she had work for 28 years. Julie started her career as office manager then moved into a variety of roles including quality co-ordinator, clinical effectiveness facilitator in mental health services, clinical governance lead within a community health partnership, business manager within a health & social care partnership and more recently her role prior to starting at the Commission was as a service manager within public health.
Arun Chopra - executive director (medical)
Arun has been with the Commission since 2019, initially as a consultant psychiatrist for safeguarded treatments before being appointed medical director in 2020. Prior to taking up his current role, he was a consultant psychiatrist in Edinburgh; Wellington, New Zealand; and in Nottingham where he trained in psychiatry. On a career break from medicine he worked as a House of Commons clerk through the Civil Service Fast Stream. He has post-graduate qualifications in psychiatry, medical law and ethics and has several academic publications in the field of mental health law. He was a member of sub-groups of the Independent Reviews of mental health law in England (2018/19) and in Scotland (2020/21). A previous recipient of the College’s Laughlin prize, he is a Fellow of the Royal College of Psychiatrists.
Claire Lamza - executive director (nursing)
Claire joined the Commission in 2017 as a nursing officer. She then became one of the first senior managers in the organisation, before her recent appointment in 2022 as executive director (nursing). Claire has held a number of clinical and operational roles across a range of healthcare settings prior to joining the Commission. She has maintained an interest in specific areas such as forensic mental health and rehabilitation. As the most senior professional nurse within the Commission, Claire has worked with the Royal College of Nursing as a forum chair and more recently on the RCN Board (Scotland); she is also an active member of the Mental Health Nurses Forum (Scotland).
Suzanne McGuinness - executive director (social work)
Suzanne joined the Commission in 2021 as executive director (social work). Suzanne studied law and then social work. She has experience of working in legal roles, in prisons and across a number of roles in a large health and social care partnership area, most recently as the professional social work lead for the partnership reporting to the director. Suzanne has a keen interest in the law and rights-based practice and has experience of working with people of all ages in the community in both statutory and third sector organisations, in addition to working with people within prisons and people affected by imprisonment in the community.
We work across the whole of Scotland. Our visiting, monitoring and casework is organised across two geographical teams.
Each team consists of health and social care professionals and is supported by our administration team. Our visitors and the Commission consultant psychiatrist work across the two teams.
These teams are backed up by our corporate services team who look after our finances, human resources, information systems and communications.
For advice on mental health and incapacity law contact our Advice Line.
One of the best ways to check that people are getting the care and treatment they need is to meet with them, and ask them what they think.
We visit people in hospital, in their own home or in a care home, in secure accommodation, or in any other setting where they are receiving care and treatment. About a quarter of our visits are unannounced.
We produce reports on all of our visits to people using services, so that services can learn from them and improve the care and treatment they provide. We never identify people in our published reports.
We regularly visit mental health and learning disability services. We do this through either:
Local visits - to people who are being treated or cared for in local services, such as a particular hospital ward, a local care home, local supported accommodation, or a prison. We produce reports after each of these visits and make recommendations for change when necessary, which we will follow up if we feel progress is not being made.
We publish local visit reports on our website and you can find them here.
Themed visits - to people with similar health issues, or in similar situations, across the country.
We publish themed visit reports and you can find them here.
Welfare guardianship visits - where we visit people who have a court-appointed welfare guardian. The guardian may be a family member, friend, carer, or social worker.
Monitoring visits - where we visit people who are subject to specific areas of mental health and incapacity legislation, due to our statutory duty to monitor the operation of the law in this area. On these visits we look at compliance with the legislation, and at the experience of people who are receiving treatment. We also look for examples of good practice that we can share.
Other visits - for example, we visit when someone who is detained in hospital in England, Wales, or Northern Ireland is transferred to a hospital in Scotland. We also visit some young people admitted to an adult ward.
For advice on mental health and incapacity law contact our Advice Line.
Watch our film about our visits below.
What do we monitor?
We monitor the Mental Health (Care & Treatment) (Scotland) Act 2003 and the welfare parts of the Adults with Incapacity (Scotland) Act 2000.
The law says that the people providing care and treatment must let us know if a person has been:
We check the paperwork we receive and let the professionals responsible, and the person concerned, know if we think there is a problem. If our monitoring work shows up a serious problem, we might follow this up through a visit or an investigation.
We pull together and analyse the information we receive to create a picture of how these laws work regionally and nationally. We publish annually information on trends and provide data that allows health boards and local authorities to compare their use of the law against other parts of Scotland.
We will produce statistics and analysis on the use of mental health and incapacity legislation within six months of the end of the year.
As well as producing general monitoring and trend data on the use of mental health and incapacity law, we also produce themed visit reports on areas of care and treatment where we have particular concerns. These monitoring reports identify any issues with the way the law is used. We highlight these issues, and recommend changes, to policy makers and service providers.
We also visit a sample of people on guardianship orders.
A list of Mental Health Act and Adults with Incapacity forms, including RES forms, ADM forms and Appendix A and E.
If we think that someone with a mental illness or learning disability is not getting the right care and treatment, we will look into it.
We may conduct an in-depth investigation, if we believe there are valuable lessons to be learned across Scotland.
We are particularly keen to investigate when we think other people may be having similar problems, and where there have been mistakes that we feel other professionals could learn from. We want to help make sure the same things don't happen again to other people in similar circumstances. Sometimes, after initial investigations, we find nothing of concern. Other times, we want to look further into the case.
When we do this we publish the results and recommendations from our investigations. We then follow up with services to find out what changes they have made in response to our recommendations.
We usually find out about cases through our visits to individuals or services. We might also follow up on a call to our advice line, or if we see something in a individual's paperwork that concerns us.
Most of the time we can deal with issues by talking or writing to people, saying what our concerns are, and asking for certain actions to be taken.
If we are very concerned about an individual's care and treatment, and think that their case highlights wider concerns within the health, social care or justice system, we may decide to investigate further.
When this happens, one of our practitioners will take the case to our Operational Management Group. The group will discuss the case and decide whether a full investigation is required and what form that investigation will take. An investigation team will be set up to gather and review information.
We review individual case notes. We will ask for copies of all relevant health and social care files. Our review of files may be supplemented by correspondence with the professionals responsible for the person's care and treatment.
If the causes are not clear, or if there are conflicting views of what happened, we might decide to conduct recorded interviews with the people involved. A Commission practitioner will also talk to the person, or people, concerned and/or their family and carers to find out their views on what went wrong.
Our investigation team will review the evidence, put together a picture of what happened, suggest where things went wrong, and make recommendations for change. A report will be published and sent to the organisations that we think need to review and respond to our recommendations.
We carry out an investigation when we believe something may have gone seriously wrong with an individual's care and treatment. Here you can view all of our investigation reports.
If you need information or advice about your rights in relation to mental health care and treatment, or you are concerned about someone else's rights and welfare, we will try to help.
If we cannot help directly, we can refer you to other organisations who should be able to.
We give advice and information about rights and best practice in relation to two laws:
Our website provides answers to questions that patients and members of the public, carers, and professionals have asked us. The Scottish Government has a series of Mental Health Act Topic Guides on different aspects of the law and how these might affect you or someone you know.
If you are concerned that your care and treatment is not in line with what the law says, please contact us. We may be able to help put things right.
Our telephone service is available Monday to Thursday 9am to 5pm, and on Fridays from 9am to 4.30pm.
We use a callback system where we take brief details of your query and a contact number. This means our staff can try to look into some background on your query before calling you back.
Call us on 0131 313 8777. We also operate a freephone number, 0800 389 6809, for service users and carers only.
We produce patient service user and carer leaflets to explain our role, help people understand their rights, and to promote best practice in the use of mental health and incapacity law.
To keep the public informed about our work, we have a Twitter account.
Having a presence on this site also allows us to gauge public opinion on a variety of subjects related to our work in Scotland.
Here's a list of the kind of information we regularly communicate via social media:
We may also share information from our wider network. This may include:
When we share, or re-tweet this information, it does not imply that we endorse the message. It simply means that we think our followers might be interested.
If you follow us on Twitter, you can expect approximately ten updates per week, bringing you the latest information from our website and our work.
If you follow us on Twitter, we will not automatically follow back. Being 'followed' on Twitter by the Mental Welfare Commission does not imply endorsement of any kind.
We read all direct messages and @ messages to ensure that any emerging themes, or helpful suggestions, are passed to the relevant people in the Mental Welfare Commission. We also keep track of your Twitter replies and respond if we feel it would be appropriate to do so.
We retain the right to remove any comments that we feel to be inappropriate for a public forum.
If your public message has implications for an individual's personal identity (in line with data protection legislation) or if you publicly request information not routinely made available by us (via the Freedom of Information Act), then we will take such messages and requests offline and handle in a more appropriate manner.
For more information on Freedom of Information requests, visit the Freedom of Information section of our website.
Twitter is not the best forum for discussing individual cases. If you have an in-depth question or problem, you can phone our advice line on 0131 313 8777 or freephone 0800 389 6809 for service users and carers.
Our Twitter account is managed by a part-time member of staff, and as a result it may take us a couple of days to see or respond to messages. We do not monitor Twitter at the weekend, or outside normal working hours.
Twitter may occasionally be unavailable and we accept no responsibility for lack of service due to Facebook/Twitter downtime.
We are often described as a mental health 'watchdog'.
It is true that we look into situations where something has gone wrong in mental health and learning disability services, but we also work to improve policy to help safeguard people and prevent things going wrong.
In our watchdog role, we draw attention to mistakes and ask people to learn from them. In our 'guide dog' role, we use our unique overview of mental health and learning disability services to help Scottish Ministers and service managers shape policy. This way we aim to help develop services that safeguard rights, and improve care and treatment for people with mental illness, learning disability, dementia and related conditions.
We have a unique overview of mental health and learning disability services in Scotland. Our monitoring work and our visiting programme give us an insight not only into how government legislation is being used, but how that impacts on individual rights and effective care and treatment. We share the information we develop with government, calling for changes in national policy and legislation where we think these are required. We have representation on the Scottish Parliament's Mental Health Cross Party Group and Learning Disability Cross Party Group.
We hold annual meetings with senior executives of health boards and local authorities. At these meetings we can highlight service policy issues that we believe ought to be addressed. We ask services what they have done in response to recommendations from visits to services in their area. We also ask what they have done to act on any relevant recommendations and learning points from our investigations into care and treatment.
When we have concerns about an individual's care and treatment we report these to the people most directly responsible and ask them to take any action required. If we do not get a response, we will escalate this request further up the management level. Where an issue is very serious, and is not resolved by the services involved, we can escalate our concerns right up to Scottish Ministers.