Appeals against detention in conditions of excessive security: outcomes and decision-making

Abstract

The Mental Health (Care and Treatment) Scotland Act 2003 introduced the right for patients to appeal against detention in conditions of excessive security initially to those in high security. Aim: to further investigate appeal outcomes and to examine Tribunal decision-making. Results: responsible medical officer support, being on the transfer list and not having a diagnosis of learning disability increased the chances of a successful appeal. Qualitative analysis of the Tribunal’s decision-making produced 5 themes and 17 subthemes. These were used to develop a ‘checklist’ framework to improve understanding of relevant appeal factors. Conclusions: Neither appeal outcomes nor patient characteristics have changed over time. The checklist may be useful as a training tool and clinical guide. This study is timely given that the Mental Health (Scotland) Act 2015 extended the right of appeal against excessive security to patients detained within medium secure units from November 2015.