Publications

Guidance to help mental health practitioners interpret the legal basis for treatment in line with best legal and ethical practice. This document was reviewed and updated in 2024.

A report into the investigation examining the care and treatment of Mrs F.

How families can be involved in their relative’s care and treatment.

How families can be involved in their relative’s care and treatment.

Guidance on delivering physical healthcare to people who lack capacity and refuse or resist treatment.

Guidance on legal and practical considerations where an individual refuses treatment but lacks capacity to make a decision about medical treatment, and covert medication is being considered.

Guidance on the use of the Mental Health Act in dealing with drug-induced psychosis.

The Authority to discharge project was undertaken in response to numerous concerns raised in relation to the rights of people who were not able to express their own views being moved from hospital to care homes during the pandemic period.

Designated medical practitioners (DMPs) are appointed by the Mental Welfare Commission for Scotland to assess, and where appropriate, authorise certain treatments requested by the responsible medical officer (RMO) for people subject to compulsory treatment under the Mental Health (Care and Treatment)(Scotland) Act 2003 who do not or cannot consent.

In the context of the drive towards booster doses of the vaccine as a key part of the Scottish Government’s strategy to control Covid-19, the Commission is again experiencing an increase in calls and emails to our advice line seeking advice and guidance on vaccinations for some people who are not able to provide consent for this due to an underlying mental health condition or learning disability. We are therefore re-setting out our guidance in relation to this. This guidance note is primarily for practitioners.

The Commission has since received a number of enquiries in relation to the use of section 47 of the Act and has prompted this brief advice note to clarify the scope and limitations of this part of the legislation.

In Scotland, an advance refusal of life-sustaining treatment has no formal legal status under the 2000 Act. It is different in England and Wales under the Mental Capacity Act 2005.

Local intelligence gathering and calls to the Commission’s advice line in the early stages of the Covid-19 pandemic suggested that people who were in hospital and lacked capacity may have been moved from hospital to care homes without full understanding of the legal requirements to ensure rights are upheld and the move to care was lawful. Specific concerns related to the use or otherwise of Section 13ZA of the Social Work (Scotland) Act 1968 particularly in the context of the Coronavirus (Scotland) Act 2020 (‘the Coronavirus Act’).

This report is about the rights of some people who were moved from hospitals to care homes. This report is about people who this
happened to during the COVID-19 pandemic.

This good practice guide was previously published as an advice note in 2014. It has been reviewed in 2021.

Guidance for professionals and carers when considering rights and risks in sexual relationships involving people with a mental illness - Revised edition 2021.

Except in emergencies, the Act requires that medical treatment is authorised under a certificate granted (usually) by the medical practitioner. There may also be a welfare proxy (attorney, guardian or holder of an intervention order) with the authority to consent.

The Act, when defining incapacity, states that it must be due to either mental disorder or inability to communicate because of physical disorder. There are important differences in how these separate disorders are managed.

Guidance primarily for professionals working with young people with borderline personality disorder such as medical practitioners (mainly psychiatrists and GPs), nurses and social workers, including mental health officers.

The views of people with lived experience on supported decision making and people with a mental illness - some practicalities.

Good practice guide on alcohol-related brain damage (ARBD), assessment on capacity and use of legal powers.

Our guidance on significantly impaired decision making ability (SIDMA) and individuals with eating disorders.

Findings from our consultations with carers, looking at issues surrounding capacity. Carer opinion has been gathered from carer support meetings and discussions with individual carers, including those caring for individuals with mental illness, dementia, learning disability and autism.

Findings from our consultations with service users and carer groups, looking at issues around supported decision making and impaired judgement.

Findings from our consultations with service users and carer groups, looking at issues around supported decision making and impaired judgement.

This report - written by Colin McKay and Professor Jill Stavert - provides an analysis and discussion of some of the major issues faced by Scottish mental health and capacity legislation.

Findings from our consultations with carers, looking at issues surrounding capacity. Carer opinion has been gathered from carer support meetings and discussions with individual carers, including those caring for individuals with mental illness, dementia, learning disability and autism.

The following paper reflects the voice, experience and opinions that people with lived experience and carers, as individuals and as groups, provided for the Commission’s current work on supported decision making. 

Covert medication care pathway good practice guidance form: non-rewritable

Our advice on sexual relationships and criminal charges where the adult lacks capacity.

This advice is intended to guide people through some of the complexities that arise relating to contraception and adults who may lack capacity.

The full report on our investigation into the end of life support and treatment of Mr JL.

An executive summary of our report into the end of life support and treatment of Mr JL. (Hard copy available)

This booklet is for people who are having treatment under Part 16 of the Mental Health (Care and Treatment) (Scotland) Act, 2003.

We were asked to look at a case of a patient on clozapine therapy who had died. This is a complex area of clinical practice often involving a clozapine clinic as well as the usual CMHT and GP. While we did not conclude that there was a deficiency of care, we thought there were a number of useful learning points.

Ms AB was admitted to a rural hospital after becoming confused. We had some concerns about the legality of her care and treatment and have made recommendations, particularly on the use of medication.

This guide aimed for patients, family, friends and carers, describes the role of the Designated Medical Practitioner.

Ms R was subject to welfare guardianship. She died in 2011 after refusing treatment for suspected cervical cancer. This investigation looks at her care and treatment in the years leading up to her death.

Monitoring report on unannounced visits to people receiving treatment under the safeguards of part 16 of the Mental Health (Care and Treatment) (Scotland) Act 2003.