We carry out our statutory duties by focussing on five main areas of work. They are visiting people, monitoring the Acts, investigations, information and advice, and influencing and challenging.
This section has information about the main activities we carry out in order to fulfil this role.
Watch this short film about who we are and what we do, and read more below.
The Chair and members of the Board are appointed by Scottish Ministers in line with the Commissioner for Public Appointments in Scotland's Code of Practice.
They bring a wealth of experience and knowledge to the Commission, in using and managing mental health and learning disability services.
The Board sets the strategic direction for the Commission and ensures efficient, effective, and accountable governance.
Sandy Riddell originally trained in social work and, during a public service career of over 40 years, has held director level posts in social work, housing, education, and health and social care. He retired from the post of Fife's director of health and social care in 2016. Sandy has substantial experience at a national level in shaping policy and legislation in adult health and social care, children's services, substance misuse, and justice services. He was president of the former Association of Directors of Social Work and founded Social Work Scotland. Sandy has been a member of the Mental Welfare Commission for Scotland since 2017 before his appointment as chair in April 2019. He is currently a member of Grampian NHS Board and also has Board experience as a management consultant specialising in collaborative leadership and service integration. Sandy is passionate about the need to develop a rights-based approach for services and to fully involve the public in service design and delivery.
Safaa Baxter was born and educated in Alexandria, Egypt, where she obtained a BA degree in social work and community development in 1975. She worked as a volunteer in Clydebank and as a social worker with Strathclyde Regional Council. As a local authority employee for over 36 years, Safaa has worked at various level of seniority in social work across a number of local authorities. Until her retirement in April 2014, she was East Renfrewshire Council's chief social work officer, and head of the community health and care partnership children's, criminal justice, and addictions services. Safaa was also chair of the child protection committee, children's services plan, and alcohol and drugs partnership. Safaa also works with a number of local authorities as a consultant on the provision of children's services.
Gordon Johnston has a background in community development, urban regeneration, project development and management, and managing major funding streams. He is currently an independent consultant in mental health, specialising in peer research, user/patient involvement, and organisational development. Gordon is involved in many organisations and is currently chair of Bipolar Scotland. He was a director of Voices of Experience (VOX) for six years. He has also been a member of the delivery group of the Scottish Patient Safety Programme Mental Health since its inception.
Mary Twaddle has lived experience of mental ill health and recovery, and has been treated and supported by general adult mental health services for over 10 years. She currently works for NHS Lothian at the medium secure forensic unit, The Orchard Clinic, as a peer support worker using her own lived experience to help others in their recovery journey from life-changing mental ill health. She joined the newly created Peer Support Service 15 months ago, helping build the first peer service within a medium secure forensic unit in the UK. In her role she works with patients directly (both individually and as part of recovery focussed groups), and also works alongside all the other disciplines as part of the multi-disciplinary team, using her experience to contribute to team meetings and discussions on maintaining the recovery focused ethos of the clinic within the complexities of working in a forensic setting.
Cindy Mackie is an independent consultant with occupational experience in the public, private, and voluntary sectors and she currently performs a number of Associate roles within the area of regulation. She is a tribunal member with the Medical Practitioner Tribunal Service, where she is engaged in Fitness to Practise proceedings, serving in this capacity and also with the Nursing and Midwifery Council for eight years. She is a lay examiner in membership examinations for the Royal College of Obstetricians and Gynaecologists, and acts as a chairperson/quality assurance inspector in dental education programme inspections across the UK. She holds a position of independent assessor in Public Appointments NI and is also involved in school governance in a voluntary capacity. Cindy brings knowledge of health regulation, public protection, safeguarding, and human rights. Cindy is educated to graduate level with additional qualifications in human resource management and learning and development.
David Hall has been a consultant psychiatrist and medical manager in Dumfries and Galloway for the last 23 years. For the last 10 years, he has been clinical lead for National Health Improvement Programmes and is currently national clinical lead of the Scottish Patient Safety Programme in mental health. David's skills are in clinical leadership and the application of improvement science to mental health systems.
Nichola Brown joined the Board in April 2019, as carer representative. She cares for her son who has severe learning disability and complex needs, and brings experience of the challenges for families of navigating services. She has a background in community development and has worked in Public Health within Glasgow for over twenty years.
Nichola is employed by NHS Greater Glasgow and Clyde as a Health Improvement Manager in Glasgow City Health and Social Care Partnership. She leads the Health Improvement Team in North East Locality and has a city role for children aged 0-8. Nichola manages a portfolio of work programmes to improve population health, with particular focus on reducing health inequalities.
She established a community organisation in North Lanarkshire, PlayPeace, following a successful pilot in the summer of 2016 and is chairperson in a voluntary capacity. The service offers play sessions and outings to support families of children with additional needs during school holiday periods and it continues to grow and develop its services, driven by families and the children and young people engaged.
The teams who do the day-to-day work of the Commission and are the first point of contact for the public.
The Executive team carries out the strategic leadership and management of the Commission.
We work across the whole of Scotland. Our visiting, monitoring and casework is organised across two geographical teams.
Each team consists of health and social care professionals and is supported by our administration team. Our visitors and the Commission consultant psychiatrist work across the two teams.
These teams are backed up by our corporate services team who look after our finances, human resources, information systems and communications.
For advice on mental health and incapacity law contact our Advice Line.
One of the best ways to check that people are getting the care and treatment they need is to meet with them, and ask them what they think.
We visit people in hospital, in their own home or in a care home, in secure accommodation, or in any other setting where they are receiving care and treatment. About a quarter of our visits are unannounced.
We produce reports on all of our visits to people using services, so that services can learn from them and improve the care and treatment they provide. We never identify people in our published reports.
We regularly visit mental health and learning disability services. We do this through either:
Local visits - to people who are being treated or cared for in local services, such as a particular hospital ward, a local care home, local supported accommodation, or a prison. We produce reports after each of these visits and make recommendations for change when necessary, which we will follow up if we feel progress is not being made.
We publish local visit reports on our website and you can find them here.
Themed visits - to people with similar health issues, or in similar situations, across the country.
We publish themed visit reports and you can find them here.
Welfare guardianship visits - where we visit people who have a court-appointed welfare guardian. The guardian may be a family member, friend, carer, or social worker.
Monitoring visits - where we visit people who are subject to specific areas of mental health and incapacity legislation, due to our statutory duty to monitor the operation of the law in this area. On these visits we look at compliance with the legislation, and at the experience of people who are receiving treatment. We also look for examples of good practice that we can share.
Other visits - for example, we visit when someone who is detained in hospital in England, Wales, or Northern Ireland is transferred to a hospital in Scotland. We also visit some young people admitted to an adult ward.
For advice on mental health and incapacity law contact our Advice Line.
Watch our film about our visits below.
What do we monitor?
We monitor the Mental Health (Care & Treatment) (Scotland) Act 2003 and the welfare parts of the Adults with Incapacity (Scotland) Act 2000.
The law says that the people providing care and treatment must let us know if a person has been:
We check the paperwork we receive and let the professionals responsible, and the person concerned, know if we think there is a problem. If our monitoring work shows up a serious problem, we might follow this up through a visit or an investigation.
We pull together and analyse the information we receive to create a picture of how these laws work regionally and nationally. We publish annually information on trends and provide data that allows health boards and local authorities to compare their use of the law against other parts of Scotland.
We will produce statistics and analysis on the use of mental health and incapacity legislation within six months of the end of the year.
As well as producing general monitoring and trend data on the use of mental health and incapacity law, we also produce themed visit reports on areas of care and treatment where we have particular concerns. These monitoring reports identify any issues with the way the law is used. We highlight these issues, and recommend changes, to policy makers and service providers.
We also visit a sample of people on guardianship orders.
A list of Mental Health Act and Adults with Incapacity forms, including RES forms, ADM forms and Appendix A and E.
If we think that someone with a mental illness or learning disability is not getting the right care and treatment, we will look into it.
We may conduct an in-depth investigation, if we believe there are valuable lessons to be learned across Scotland.
We are particularly keen to investigate when we think other people may be having similar problems, and where there have been mistakes that we feel other professionals could learn from. We want to help make sure the same things don't happen again to other people in similar circumstances. Sometimes, after initial investigations, we find nothing of concern. Other times, we want to look further into the case.
When we do this we publish the results and recommendations from our investigations. We then follow up with services to find out what changes they have made in response to our recommendations.
We usually find out about cases through our visits to individuals or services. We might also follow up on a call to our advice line, or if we see something in a individual's paperwork that concerns us.
Most of the time we can deal with issues by talking or writing to people, saying what our concerns are, and asking for certain actions to be taken.
If we are very concerned about an individual's care and treatment, and think that their case highlights wider concerns within the health, social care or justice system, we may decide to investigate further.
When this happens, one of our practitioners will take the case to our Operational Management Group. The group will discuss the case and decide whether a full investigation is required and what form that investigation will take. An investigation team will be set up to gather and review information.
We review individual case notes. We will ask for copies of all relevant health and social care files. Our review of files may be supplemented by correspondence with the professionals responsible for the person's care and treatment.
If the causes are not clear, or if there are conflicting views of what happened, we might decide to conduct recorded interviews with the people involved. A Commission practitioner will also talk to the person, or people, concerned and/or their family and carers to find out their views on what went wrong.
Our investigation team will review the evidence, put together a picture of what happened, suggest where things went wrong, and make recommendations for change. A report will be published and sent to the organisations that we think need to review and respond to our recommendations.
We carry out an investigation when we believe something may have gone seriously wrong with an individual's care and treatment. Here you can view all of our investigation reports.
If you need information or advice about your rights in relation to mental health care and treatment, or you are concerned about someone else's rights and welfare, we will try to help.
If we cannot help directly, we can refer you to other organisations who should be able to.
We give advice and information about rights and best practice in relation to two laws:
Our website provides answers to questions that patients and members of the public, carers, and professionals have asked us. The Scottish Government has a series of Mental Health Act Topic Guides on different aspects of the law and how these might affect you or someone you know.
If you are concerned that your care and treatment is not in line with what the law says, please contact us. We may be able to help put things right.
Our telephone service is available Monday to Thursday 9am to 5pm, and on Fridays from 9am to 4.30pm.
We use a callback system where we take brief details of your query and a contact number. This means our staff can try to look into some background on your query before calling you back.
Call us on 0131 313 8777. We also operate a freephone number, 0800 389 6809, for service users and carers only.
We produce patient service user and carer leaflets to explain our role, help people understand their rights, and to promote best practice in the use of mental health and incapacity law.
To keep the public informed about our work, we have a Twitter account.
Having a presence on this site also allows us to gauge public opinion on a variety of subjects related to our work in Scotland.
Here's a list of the kind of information we regularly communicate via social media:
We may also share information from our wider network. This may include:
When we share, or re-tweet this information, it does not imply that we endorse the message. It simply means that we think our followers might be interested.
If you follow us on Twitter, you can expect approximately ten updates per week, bringing you the latest information from our website and our work.
If you follow us on Twitter, we will not automatically follow back. Being 'followed' on Twitter by the Mental Welfare Commission does not imply endorsement of any kind.
We read all direct messages and @ messages to ensure that any emerging themes, or helpful suggestions, are passed to the relevant people in the Mental Welfare Commission. We also keep track of your Twitter replies and respond if we feel it would be appropriate to do so.
We retain the right to remove any comments that we feel to be inappropriate for a public forum.
If your public message has implications for an individual's personal identity (in line with data protection legislation) or if you publicly request information not routinely made available by us (via the Freedom of Information Act), then we will take such messages and requests offline and handle in a more appropriate manner.
For more information on Freedom of Information requests, visit the Freedom of Information section of our website.
Twitter is not the best forum for discussing individual cases. If you have an in-depth question or problem, you can phone our advice line on 0131 313 8777 or freephone 0800 389 6809 for service users and carers.
Our Twitter account is managed by a part-time member of staff, and as a result it may take us a couple of days to see or respond to messages. We do not monitor Twitter at the weekend, or outside normal working hours.
Twitter may occasionally be unavailable and we accept no responsibility for lack of service due to Facebook/Twitter downtime.
We are often described as a mental health 'watchdog'.
It is true that we look into situations where something has gone wrong in mental health and learning disability services, but we also work to improve policy to help safeguard people and prevent things going wrong.
In our watchdog role, we draw attention to mistakes and ask people to learn from them. In our 'guide dog' role, we use our unique overview of mental health and learning disability services to help Scottish Ministers and service managers shape policy. This way we aim to help develop services that safeguard rights, and improve care and treatment for people with mental illness, learning disability, dementia and related conditions.
We have a unique overview of mental health and learning disability services in Scotland. Our monitoring work and our visiting programme give us an insight not only into how government legislation is being used, but how that impacts on individual rights and effective care and treatment. We share the information we develop with government, calling for changes in national policy and legislation where we think these are required. We have representation on the Scottish Parliament's Mental Health Cross Party Group and Learning Disability Cross Party Group.
We hold annual meetings with senior executives of health boards and local authorities. At these meetings we can highlight service policy issues that we believe ought to be addressed. We ask services what they have done in response to recommendations from visits to services in their area. We also ask what they have done to act on any relevant recommendations and learning points from our investigations into care and treatment.
When we have concerns about an individual's care and treatment we report these to the people most directly responsible and ask them to take any action required. If we do not get a response, we will escalate this request further up the management level. Where an issue is very serious, and is not resolved by the services involved, we can escalate our concerns right up to Scottish Ministers.