Emergency Detention Certificates with Mental Health Officer consent remains low

The proportion of emergency detention certificates (EDCs) authorised with the consent of a mental health officer (MHO) has fallen to 38.6%, down from 56.0% in 2014-15. This marks a decade of decline in an important safeguard intended to protect the rights and liberty of individuals detained under mental health legislation.

The data from our 2024-25 report confirms that EDCs without MHO consent are no longer exceptional, contrary to Recommendation 12.8 of the Scottish Mental Health Law Review, which explicitly states that such instances should be rare.

Regional disparities are pronounced. On the Scottish mainland, MHO consent rates during 2024-25 ranged from 27.0% in NHS Greater Glasgow and Clyde up to to 81.4% in NHS Dumfries and Galloway. Boards that previously demonstrated high performance have seen substantial declines since 2016: NHS Tayside fell from 80.0% to 47.6%; NHS Fife from 77.0% to 43.1%; and NHS Highland from 74.0% to 59.4%.

Age-based disparities further compound concerns. Individuals under the age of 25 are the least likely to have an MHO involved, with a consent rate of just 32.0%, compared to 36.8% for those aged 25 to 64 and 44.5% for those aged 65 and over. The most vulnerable individuals requiring the protection of mental health legislation are therefore now less likely to benefit from independent scrutiny at the point of detention.

An EDC, which may be issued by any registered medical practitioner, authorises detention in hospital for up to 72 hours. The MHO provides an independent, critical evaluation of the proposal to detain, identifies alternatives to compulsory admission, facilitates the individual's understanding of their rights, and safeguards their property and possessions. The Mental Health (Care and Treatment) (Scotland) Act 2003 requires MHO consent in as many cases as practically achievable.

The Commission expects health and social care partnerships (supported by their health boards and local authorities) to undertake their own audits to identify and address the reasons why MHOs are not being involved in decisions to detain vulnerable young people and adults in their areas. The Commission will seek assurance to confirm that appropriate action is being taken to maximise MHO involvement where decisions about a person’s liberty, care and treatment are being made.