Mental health (national secure adolescent inpatient service: miscellaneous amendments) (Scotland) regulations 2023: children's rights and wellbeing impact assessment

Conclusion

7. As a result of the evidence gathered and analysed against all UNCRC requirements, what is the potential overall impact of this proposal on children’s rights?

The overall impact on children’s rights is positive.

Amendments to the Regulations will support provision of a medium secure mental health inpatient service for children and young people who need this level of care closer to home, without which appropriate care facilities are not available in Scotland.

Some of the Measures that can be applied by these Regulations will impact on children’s rights, however, they will be applied as minimally as possible. As set out above, there are various safeguards built into the use of the Measures that seek to both protect rights and safety. The application of the Measures are to help protect the safety of all children and young people who require to be detained in the NSAIS, in conditions of medium security. The Measures will be applied on an individual basis, only when necessary, and they will be proportionate to the potential risk.

If the Measures are not applied to the new service, it may mean that the service is not able to manage the risks the young people pose to themselves and others and therefore cannot provide the intended safe therapeutic environment for patients or for visitors and staff.

There are, however, various safeguards built into the use of the Measures which seek to protect rights while protecting safety. These include the conditions on when and how the Measures can be used, record keeping, and oversight and scrutiny by the Mental Welfare Commission.

These all act as safeguards on the rights of the children and young people who may be detained in the NSAIS, while enabling necessary Measures to be taken to ensure their safety.

8. If you have identified a positive impact on children’s rights, please describe below how the proposal will protect, respect, and fulfil children’s rights in Scotland.

These Regulations will uphold the rights of children and young people detained in conditions of medium security and provide for protective Measures to safeguard vulnerable individuals and protect their rights within this setting.

9. If a negative impact has been identified please describe it below. Is there a risk this could potentially amount to an incompatibility?

As identified above, some of the Measures that can be applied by these Regulations will impact on children’s rights,

Children and young people admitted to the NSAIS will be cared for within a secure setting. Therefore, they will be separated from family and will be subject to Measures on their freedom, movement, and activity. However, the Measure will be applied as minimally as possible.

Mitigation Record

There are various safeguards built into the use of the Measures which seek to protect rights while protecting safety. These include the conditions on when and how the Measures can be used, record keeping, and oversight and scrutiny by the Mental Welfare Commission. These all act as safeguards for the rights of the children and young people who may be detained in the NSAIS, while enabling necessary Measures to be taken to ensure their safety.

To mitigate a negative impact as a result of children and young people being deprived of their liberty and away from parents, prior to admission and throughout their stay in the NSAIS, children and young people will be involved in supported decision-making around all aspects of their care and treatment. This will include providing young patients with clear and accessible information about the secure environment and procedures that apply to all patients, and any that relate to them individually.

The multidisciplinary team will use approaches and tools, such as communication aids, to facilitate their understanding. The child or young person's capacity to make decisions about Measures relating to safety and security will be regularly assessed and reviewed by the Responsible Medical Officer.

10. As a result of the evidence gathered and analysed against all wellbeing indicators, will the proposal contribute to the wellbeing of children and young people in Scotland? (Guidance Section 2.3.2, pages 20-22).

Safe: Yes

Healthy: Yes

Achieving: Yes

Nurtured: Yes

Active: Yes

Respected: Yes

Responsible: Yes

Included: Yes

If yes, please provide an explanation below:

The main function of the NSAIS will be to ensure that children and young people requiring a medium secure level of security are able to receive high quality mental health care and treatment that is suitable for their age and developmental stage.

The multidisciplinary team will have a unique role in ensuring that every aspect of care, including the nature of the building, the procedures that take place in it and the clinical aspects of care, are delivered under the principles of the Mental Health (Care and Treatment) (Scotland) Act 2003. That includes the principle of meeting the welfare needs of the child young person.

11. How will you communicate to children and young people the impact that the proposal will have on their rights?

Guidance will be provided ensuring that children and their families are aware of their rights and how these will be upheld.

Patient and carer information sheets are in development by NHS Ayrshire and Arran following feedback from young people in a secure unit in England.

The CRWIA will be published on the legislation.gov.uk website alongside the SSI so those wishing to access it can do so.