Consultation on Updates to the Code of Practice for the Mental Health (Care and Treatment) (Scotland) Act 2003

Scope of the proposed update

This update to the Code of Practice is intentionally focused on specific priority areas. While we recognise that the Code of Practice would benefit from a more comprehensive review, this targeted update reflects the urgency of concerns raised about restraint and seclusion and our commitment to act promptly in this area. We remain committed to updating all three volumes of the Code as part of wider Mental Health Law reform.

The proposed revisions to the Code of Practice include guidance on:

• clear definitions of restraint and seclusion
• the lawful limits of restraint, including safeguards required to comply with human rights obligations and examples of practices that could amount to unlawful restraint
• the use of restraint and seclusion with children and young people, grounded in UNCRC principles: use as a last resort, the best interests of the child, the child’s right to be heard, and the provision of age‑appropriate care
• the use of restraint in relation to people with learning disabilities or autistic people, in line with non‑discrimination principles in the 2003 Act, the UNCRPD and the UNCRC
• the use of restraint in the specific context of nasogastric tube feeding.

Alongside this, the Mental Welfare Commission for Scotland will undertake national reporting on the use of restraint and seclusion in inpatient mental health units, as recommended by the Scottish Mental Health Law Review. The Commission will work with Health Boards to improve and standardise data collection, enabling national‑level understanding and monitoring of restraint and seclusion.

This content set out in this chapter is high level and does not offer detailed operational guidance. We are committed to developing further guidance on the use of restraint and seclusion, and a more comprehensive update to the Code of Practice in due course. Through this consultation, we invite your views on whether more detailed guidance would be welcome.

Supporting staff and services

We recognise that practitioners and services work hard, often under significant pressure, to provide care to some of the most vulnerable people in society. This update to the Code of Practice is intended to be supportive, to help health boards develop clear protocols, and staff make difficult decisions in line with human rights principles, promoting consistency and confidence in practice across Scotland.