Section Three The second year – activities and key issues by type of detention Scotland In Scotland, the Mental Welfare Commission for Scotland (MWCS) is mandated to visit and monitor the treatment of anyone detained under mental health law. In 2010–11, it visited 1,925 people with mental disorder in a variety of settings, most of whom were subject to compulsory mental health treatment or welfare guardianship. MWCS also conducted 98 focused visits to mental health or learning disability facilities where it had identified a greater risk that people were not having their needs met or their rights respected. Of these visits, 21 were unannounced. The visits resulted in 301 recommendations for improvement. MWCS has identified a number of key issues in the course of its work. It is concerned about young people being admitted to adult wards and a lack of attention to regulations on searches, the taking of samples and restricting communications. It has also highlighted the lack of attention to the physical health of people with severe and enduring mental illness. People detained in hospitals often gain weight due to medication and inactivity. MWCS recommends that access to exercise, dietary advice and regular screening for health risks must improve. In addition to its regular visits to places of detention, MWCS conducts thematic reviews, which often include information about people who are detained. This year, MWCS published reports on people with dementia in hospital; people receiving compulsory treatment after committing an offence; people in learning disability facilities; people in adult acute mental health wards; and people with acquired brain injury and alcohol-related brain damage. MWCS also publishes good practice guides. This year, it published a guide on supporting the right of people with mental disorder to have sexual relationships while being free from abuse or exploitation.33 • a person is twice as likely to be treated under compulsion in Fife than in the Borders • there is some evidence of a disproportionately high use of compulsion for black African and Caribbean people • women are more likely to be detained under emergency orders, while men are more likely to be subject to long-term orders. As well as its general monitoring function, MWCS may also carry out investigations. In 2010, it published a report of an investigation of the case of a woman who died by suicide while detained in hospital. It found that nobody had got to grips with her mixture of mental illness, alcohol use and social problems. MWCS is concerned about variations in the use of compulsory treatment: Despite its numerous concerns about mental health detention, MWCS has noted that progress was made in 2010–11. It believes that care for people with dementia is improving and is positive about a fall in the use of emergency detention. Its report on visits to people receiving compulsory treatment after committing an offence was largely positive, in that it found good attention to individual needs and rights; that levels of security were not excessive; and that the people visited were generally appreciative of the care they received. 33 All MWCS publications are available online at www.mwcscot.org.uk/newpublications/mwc_publications.asp. 39