A shortage of social workers in Scotland is placing the welfare of mental health patients at risk, according to sector leaders. The Scottish Association of Social Work (SASW), Social Work Scotland, and the Mental Welfare Commission for Scotland (MWC) have issued a warning in response to data from MWC showing a decline in the proportion of emergency detentions with consent from mental health officers (MHO).

 

MHOs, who are specialised mental health social workers, provided consent in only 36.6% of cases in 2022-23, down from 40.4% in the previous year. This rate has remained below 50% for six years, as reported by MWC. Consequently, in almost two-thirds of cases, only a doctor is involved in the decision to issue an emergency detention certificate (EDC), which allows a person to be held in a hospital for up to 72 hours. This deficiency in patient safeguards is deemed “unacceptable” by MWC.

 

The role of MHO consent is to protect the rights of the potentially detained person, as per the code of practice on the 2003 act. They should consider the individual’s views on detention, assess their personal and social circumstances, and explore less restrictive alternatives before granting consent.

 

One of the challenges in obtaining MHO consent for an EDC is the tight timeframe involved, as the certificate must be produced on the day of examination or within four hours if the examination occurs after 8 pm.

 

The MWC identified significant variations in the proportion of cases with MHO consent across health board areas, linked to workforce shortages. The number of MHOs employed by councils decreased from 709 to 660 between 2017-21, before increasing to 670 in the last year. However, there is still a shortfall in MHO capacity, resulting in a lack of safeguards for patients.

 

SASW, Social Work Scotland, and MWC all highlight MHO shortages as a contributing factor to this issue, emphasising the need to improve the terms and conditions for these specialist social workers to attract new talent to the profession.

 

The MWC’s report suggests that an EDC without MHO consent should only occur in “exceptional circumstances,” a recommendation endorsed by the Scottish Mental Health Law Review. The Scottish Government has committed to modernising legislation but has not outlined specific measures to address the safeguarding deficit. The sector calls for a more strategic and long-term approach based on the Scottish Mental Health Law Review, currently under consideration by the government.

 

The report from the MWC can be found here:

 

https://www.mwcscot.org.uk/news/rising-number-detentions-mental-ill-health-scotland-falling-safeguards

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