SIAA’s response to the Scottish Government’s consultation on updates to the Mental Health (Care and Treatment) (Scotland) Act 2003 Code of Practice
The Scottish Government has consulted on proposed updates to volume 1 of the Code of Practice for the Mental Health (Care and Treatment) (Scotland) Act 2003. The Code was first published in October 2005 and has not been updated since, and this round of changes concentrates on the use of restraint and seclusion in hospital. The Government has described this as a limited, targeted update, with more comprehensive revisions to all three volumes of the Code expected as part of wider mental health law reform.
SIAA’s response, submitted in October 2026, draws on the experience of member organisations working in hospitals, forensic settings and communities across Scotland. Particular thanks to Ceartas, The Patient’s Advocacy Service, Borders Independent Advocacy Service (BIAS) and The Advocacy Project for sharing their views and expertise with us for the response.
We welcomed the proposed new chapter and the rights-based approach it takes, including its clear definitions, its guidance on the lawful limits of restraint, and its specific attention to children and young people, to autistic people and people with learning disabilities, and to nasogastric tube feeding. Members told us this guidance fills a gap, and that the impact of restraint and seclusion on the people they provide independent advocacy to can be profound and long-lasting.
Our central message is that independent advocacy must be written into the new chapter properly, rather than mentioned in passing. We are asking the Scottish Government to:
- describe advocacy consistently as independent advocacy, recognising that independence is what makes it a safeguard;
- recognise independent advocacy as a right under the 2003 Act and embed it at every stage of a restraint or seclusion incident, while stating clearly that advocacy involvement is not evidence that a restrictive practice was properly applied;
- broaden the definitions of restraint and seclusion to reflect the restrictions members described, including limits on contact with family and friends, on access to fresh air and outdoor space, and on access to personal electronics;
- require monitoring and recording of whether people were told about, and able to access, independent advocacy — including referrals, acceptance rates, reasons for declined referrals and waiting times;
- require staff training on what independent advocacy is and how to refer to it, co-designed with SIAA and our member organisations;
- set out clear routes to challenge decisions and seek redress, and commit to the stronger legal safeguards that only legislative reform can provide.
SIAA also echoes the Scottish Human Rights Commission in warning that guidance alone cannot substitute for stronger safeguards in law. We have urged the Government to set out a clear timetable for implementing the recommendations of both the 2022 Scottish Mental Health Law Review (Scott Review) and the 2019 Learning Disability and Autism in the Mental Health Act Review (Rome Review), and to resource independent advocacy so that the rights set out in the Code can actually be realised.
For more information, you can access versions of the Scottish Government’s consultation paper below.
Consultation text – full version
Easy Read – Consultation text (Restraints and seclusion)
Summary version of consultation paper – Update to the Code of Practice on the Use of Restraint
