Maree Todd MSP, Minister for Mental Wellbeing, Social Care & Sport (photo), replied on 27 December to the email which I sent to the Scottish Government on behalf of the Petition on 14 November 2023.
Whilst it is gratifying that the Minister has replied in person instead of getting a Civil Servant to do so, her reply is a step backward from the promise of her predecessor (Kevin Stewart MSP) to “do better.”
The Minister disagrees with our statements that the 4 young men who are 'Locked In The Hospital' are incarcerated unnecessarily and are not getting any therapeutic benefit from it, and that the 2 young men imprisoned in The State Hospital do not meet the required level of risk of serious harm to the public for their detention in High Secure conditions to be appropriate and necessary. However she does not give any reasons for her disagreement.
The Minister rejects what the mothers are telling her. She has made up her mind solely on the basis of what the hospitals and her medical advisers are telling her. She does not have any experience of her own and has not investigated both sides of the dispute.
Like the hospitals involved, the Minister uses the excuse of 'patient confidentiality and data protection' to avoid discussion of individual cases and disclosure of relevant information – the patients involved have not refused consent and their mothers do not need permission.
We shall be drafting a reply to the Minister in the hope of encouraging her to discuss the true issues – which she says that she agrees with. We shall also work towards re-introducing our Petition into the Scottish Parliament, which was closed promptly in January 2021. This will put further pressure on the Scottish Government to address the true issues.
Barry Gale
on behalf of the Petitioners
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LETTER FROM THE MINISTER :
From : scottish.ministers@gov.scot
To : Barry Gale mhrscot@gmx.co.uk
Our Reference: 202300385901
Your Reference: “Locked In the Hospital Protest” at the Scottish Parliament
27 December 2023
Dear Barry and petitioners
Thank you for your letter dated 13 November 2023 addressed to the First Minister, regarding your recent campaign at the Scottish Parliament. I am replying as this sits within my portfolio responsibility as Minister for Social Care, Mental Wellbeing and Sport.
I am aware of the four individuals that you referred to in your petition and understand that you and the other signatories have concerns about their circumstances. I know you have corresponded extensively on this subject over the past few years, and the previous Minister for Mental Wellbeing and Social Care also discussed these cases with the families.
It might be helpful to start by recognising that each individual has a unique history and set of circumstances that inform clinical, legal and wellbeing decisions. Due to data protection it is not appropriate for me as a Minister to comment on individual cases and I must also be absolutely clear it is not my role to intervene in any way in clinical decisions about specific individuals.
However, I would like to use this letter to reassure readers that hospital is not a home for anyone and no-one should be spending longer in hospital than is medically necessary. Our priority is on reducing inappropriate hospital stays and inappropriate out-of-area placements for people with complex care needs.
You state in your letter that all 4 men ‘are detained inappropriately and unnecessarily in conditions of excessive security’ and I want to take this opportunity to set out that I do not agree with this statement. You also reference two individuals at The State Hospital and state ‘Their behaviour does not meet the Forensic Network's Guidance on referral to High and Medium Security’. I also do not agree with this statement.
However, you go on to state what you view as a number of problems and these are mostly around risks of institutionalisation, attitudes to risk management and a greater involvement of lived experience. I broadly agree with these points and want to reassure you that these points are wholly aligned with the Coming Home programme of work ambitions, and the spirit of the work we are progressing.
I recently wrote to the Scottish Parliament’s Health and Sport Committee to update them on progress towards Coming Home (see Link below), and you can read my letter on the parliament’s website.
One area I want to draw specific attention to is the implementation of the new Dynamic Support Registers in May this year, which aim to improve the case management of people with learning disabilities and complex care needs in local areas. A significant amount of work was put into developing the associated guidance for the Registers and a key part that is clear in the registers and guidance is:
It is important to ensure there is meaningful engagement with the person and those supporting them when reviewing support arrangements to ensure that their views and choices are included as a priority. (DSR Guidance, May 2023)
We are working collaboratively with the NHS, Integration Authorities, Local Authorities and care providers to ensure this guidance is embedded and will improve local case management and planning for people with learning disabilities and complex care needs.
This guidance only launched a few months ago, but rest assured we will continue to monitor the rollout of the registers over the coming months. We are exploring how the proposed Learning Disability, Autism and Neurodivergence Bill can strengthen our work on the Coming Home programme, in particular the recommendation to establish a National Support Panel and whether opportunities exist to strengthen the work on the Dynamic Support Registers. A public consultation will launch by the end of 2023 (the consultation is already open – see link below).
In addition, we are undertaking a review of our Scottish Mental Health Law and will look at how we can update and modernise our mental health and capacity legislation to better reflect international human rights standards. We will keep Coming Home under review as this work progresses.
We are working on developing ways to share best practice across the country and Integration Authorities are using £20 million from our Community Living Change Fund to design community-based solutions that avoid or limit future hospital use and out-of-area placements.
We are committed to improving our capacity and capability to manage complex care in Scotland. I am proud that we have a really clear and strong vision set out in the Coming Home Implementation Report, and will continue to work in partnership with COSLA and practitioners to make this change happen.
I started my letter by explaining that I am unable comment specifically on the cases you have raised. However I want to end by reiterating some of what we have discussed in our previous correspondence and what the previous Minister covered when meeting with the parents of these men.
I must reiterate that a diagnosis of autism or a learning disability in itself is not a cause of detention in the State Hospital. The Mental Health (Care and Treatment) (Scotland) Act 2003 requires a number of criteria to be met before a person can be treated under the Act and there are significant safeguards where compulsory treatment is necessary. There are times where individuals are not yet ready to be discharged into the community for their own or other people’s safety. As a result, they may be in secure hospital settings for an extended period of time to receive necessary care and treatment.
I have provided some further information on Scottish Mental Health law, and the safeguards that are in place, in Annex A (attached) for those who want more detail.
I hope this letter is informative. I cannot and will not be in a position to provide further information about the specific cases mentioned given my obligations to respect patient confidentiality and data protection law.
Yours sincerely
Maree Todd MSP
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LINKS (to be added later) :
1. Letter to Health & Sport Committee updating them on progress towards Coming Home.
2. Consultation on Learning Disability, Autism & Neurodivergence Bill (closes 21 April 2024)
https://consult.gov.scot/mental-health-unit/learning-disabilities-autism-neurodivergence-bill
3. Public Petition to the Scottish Parliament PE01849: Independent review of non-forensic detentions within high and medium secure psychiatric hospitals