Appeals against detention in conditions of excessive security in Scotland

The Mental Health (Care and Treatment)(Scotland) Act 2003 introduced the provision for patients to appeal against being treated in conditions of excessive security for the first time. In this article, we examine the first 100 patients to appeal using this new provision. We compared the clinical, demographic and legal factors of these patients depending upon the outcome of the appeal. Forty-four per cent of appeals were successful compared with 22% which were rejected. There was no difference on any clinical factors studied between these groups. The main difference between the groups was that those patients who had the support of their Responsible Medical Officer and were already on the transfer list were significantly more likely to succeed p .000. We have demonstrated that legislation is an important mechanism to drive change in any forensic mental health system such as the development of medium and low secure services in Scotland.