Section one Context while a voluntary inpatient in a mental health hospital.15 On the related issue of deaths in detention, in December 2018 the Scottish Government published a review of arrangements for investigating the deaths of patients being treated for mental disorder and set out a plan of action.16 The key action was for the Mental Welfare Commission for Scotland to develop a system for investigating all deaths of patients who, at the time of death, were subject to an order under either the Mental Health (Care and Treatment) (Scotland) Act 2003 or part VI of the Criminal Procedure (Scotland) Act 1995 (whether in hospital or in the community, including those who had their detention suspended). The long-awaited report of an independent Review of the Mental Health Act 1983 (for England and Wales) was published in December 2018.17 This highlighted three key challenges in the current application of the Act: the complex balance between respecting a person’s autonomy and the duty of a ‘civilised State’ to protect the vulnerable under different Articles of the European Convention on Human Rights; the problem of fear – held by patients, the public, and professionals involved in the system; and the rise of coercion and the continuing legacy of stigma, discrimination and racism in society. The Review acknowledged that there was no simple solution but concluded that patients should be supported to make more choices for themselves and recommended a new right of appeal against compulsory treatment. In March 2019, the Scottish Government announced an independent review of the Mental Health (Care and Treatment) (Scotland) Act 2003 with the aim of improving rights and protections for those living with mental illness and removing barriers for those who care for their health and welfare. The Review will examine developments in mental health law and practice on compulsory detention and on care and treatment since the current legislation came into force in 2005.18 It will build on a review previously announced, which is specifically looking at how mental health law affects people with learning disabilities and autism.19 In Wales, work has been ongoing to improve the quality of social care. Provisions in the Regulation and Inspection of Social Care (Wales) Act 2016 (RISCA) – requiring different types of providers of care and support, including those delivering services in secure establishments, to register with Care Inspectorate Wales – were implemented between April 2018 and April 2019 (see 15 INQUEST, November 2018, Family celebrate lasting legacy as ‘Seni’s Law’ receives Royal Assent, https://www.inquest.org. uk/senis-law-assent [accessed 04/12/19] 16 Scottish Government, December 2018, Review of the arrangements for investigating the deaths of patients being treated for mental disorder, https://www.gov.scot/publications/review-arrangements-investigating-deaths-patients-being-treatedmental-disorder/ [accessed 04/12/19] 17 HM Government, December 2018, Modernising the Mental Health Act, https://assets.publishing.service.gov.uk/ government/uploads/system/uploads/attachment_data/file/778897/Modernising_the_Mental_Health_Act_-_increasing_ choice__reducing_compulsion.pdf [accessed 04/12/19] 18 Scottish Government, March 2019, Review of the Mental Health Act, https://news.gov.scot/news/review-of-the-mentalhealth-act [accessed 04/12/19] 19 The report was published in December 2019. IRMHA, December 2019, The Independent review of Learning Disability and Autism in the Mental Health Act, Final Report, https://www.irmha.scot/wp-content/uploads/2020/01/IRMHA-Finalreport-18-12-19-2.pdf [accessed 04/02/20] 17