A new national health board should be established to improve accountability and consistency across services for people whose mental illnesses lead to them offending or make them a risk to others, an independent review has concluded.

Current inpatient and community forensic mental health services should be brought together under a new board, according to the Independent Review into the Delivery of Forensic Mental Health Services.

The recommendation is one of more than 60 made following a review led by Derek Barron, Director of Care at the charity Erskine into forensic mental health services – those that specialise in the assessment, treatment and risk management of people with a mental disorder who are currently undergoing, or have previously undergone, legal or court proceedings.

The report makes recommendations to address human rights issues that have arisen as under-pressure services caused some people to be detained in ‘conditions of excessive security’ while waiting for either a space in lower secure services or community provision to support their discharge.

A high secure service for women should be re-instated ‘at the earliest opportunity’, the report states, and a national framework for the provision of court reports by psychiatrists and psychologists should also be introduced.

Review Chair Derek Barron said he hopes today’s report can guide the establishment of a forensic mental health system that “works holistically to offer a smooth and consistent rehabilitative pathway” for individuals being cared for and service staff:

“Our forensic mental health services have developed organically over the years, responding to local pressures and demands.  

“These services are characterised by a great deal of hard work, skill and good will but the systemic variation and pressures on capacity result in inefficiencies and inequalities that could be avoided.”

He added: “One of my key recommendations is the establishment of a new NHS Board to bring together our existing services into an integrated and co-ordinated forensic mental health system. 

“This would provide the greater level of accountability and transparency that I believe is required for services involved in restricting people’s liberty. 

“It also presents an opportunity to re-imagine how forensic mental health services should be delivered in Scotland.

“I want to thank everyone who shared their time, experiences, observations and opinions with the Review – the people with lived experience and their families, the staff working in these services, the members of the Review’s working groups and my employer Erskine who supported me to have time to undertake the review.”

Welcoming the report, Mental Health Minister Clare Haughey has said the government will now consider its recommendations:

“[I] recognise the important and significant work that the Review team has carried out.

“…I am grateful to everyone with lived experience, their families and carers as well as those working to deliver forensic mental health services for their input at every stage of this review. 

“The contribution of all participants has been integral to the work of the review and has helped inform the final recommendations. 

“The Scottish government will now fully consider these recommendations to ascertain how to better fulfil our obligation to provide forensic mental health care to all who need it in Scotland.”

Read more: Call for mental illness detention times to be cut; Chairs of mental health reviews announced

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