National Preventive Mechanism Eleventh Annual Report 2019–20 MWCS published a themed visit report, Autism and complex care needs, in October 2019. This was based on visits undertaken in the previous year. The report made a number of recommendations including: reducing the use of medication for managing behaviours seen as challenging; addressing issues about the use of restraint and seclusion; and addressing the issue of delayed discharges which in many cases compromised human rights as enshrined in Article 19 of the United Nations Convention on the rights of Persons with Disabilities (UNCRPD).141 MWCS completed an investigation and published a report in September 2019 which examined a case in which a woman with learning disabilities and other care needs, who had been admitted to hospital following a neck fracture, was not discharged from hospital until 18 months after she had been deemed fit to leave. The Commission felt this delay impacted on her human rights. The dispute arose primarily because the health and social care partnership believed the woman should move to a care home, while the family wanted her to return home (where she eventually returned and now lives successfully with the support of her family and social care). The report contains recommendations for the specific organisation involved, and for similar organisations across Scotland.142 In England, NHS data shows that in 201920 there were more than 50,893 new detentions under the Mental Health Act, with an estimated overall increase of 0.8% from last year. Among the five ethnic groups, known rates of detention for the ‘Black or Black British’ group were over four times those of the ‘White’ group. Among age groups, the detention rates for the 18-34 group were 40% higher than those in the 50-56 group.143 In May 2019, CQC published its interim report of the review of restraint, prolonged seclusion and segregation for people with a mental health problem, a learning disability and/or autism.144 This report shares findings from visits to 35 wards where it assessed the care of 39 people. It focuses on the experience of those people cared for in segregation on a mental health ward for children and young people or on a ward for people with a learning disability or autism. Findings showed that: many of the people visited had, since childhood, been communicating their distress and needs in a way that neurotypical people may find hard to understand, and services were unable to meet their needs; a high proportion of people in segregation had autism; some of the wards did not have a built environment that was suitable for people with autism; and many staff lacked the necessary training and skills. CQC also found that several people visited were not receiving high quality care and treatment, while some were experiencing delayed discharge from hospital, and therefore prolonged time in segregation, due to there being no suitable package of care available in a non-hospital 141 MWCS, October 2019, Autism and complex care needs, https://www.mwcscot.org.uk/news/more-support-neededpeople-autism-and-complex-needs [accessed 30/10/2020] 142 MWCS, September 2019, Investigation into a delayed discharge - Ms ST, https://www.mwcscot.org.uk/news/ investigation-delayed-discharge-ms-st [accessed 24/08/2020] 143 NHS Digital, October 2020, Mental Health Act Statistics, Annual Figures 2019-20, https://digital.nhs.uk/data-and-information/ publications/statistical/mental-health-act-statistics-annual-figures/2019-20-annual-figures [accessed 01/12/2020] 144 CQC, May 2020, Interim report: Review of restraint, prolonged seclusion and segregation for people with a mental health problem, a learning disability and or autism, https://www.cqc.org.uk/publications/themed-work/interim-report-reviewrestraint-prolonged-seclusion-segregation-people [accessed 24/08/2020] 46