The Scottish Government is now inviting public input on revisions to the Code of Practice under the Mental Health (Care and Treatment) (Scotland) Act 2003, specifically targeting the use of restraint and seclusion in hospitals. The consultation, which runs until 29 October 2026, seeks to strengthen protections for both adults and children, centring safety, emotional wellbeing, and fundamental human rights in every decision about physical intervention.
What's actually changing
The proposed updates to Volume One of the Code of Practice respond to growing concern about how restraint and seclusion are used in psychiatric settings — particularly with children and young people. Over the past two decades, human rights legislation has evolved significantly, and the current guidance hasn't kept pace. The revisions aim to give practitioners clearer, more consistent, and explicitly rights-based frameworks. For us as patients, families, and carers, that means the language of dignity and respect isn't left to individual interpretation — it's codified. The Mental Welfare Commission for Scotland will also begin national reporting on restraint and seclusion use, working with Health Boards to standardise data collection. This is a practical step: what gets measured gets addressed.
Why this matters beyond Scotland
The consultation is specific to Scotland, but the underlying question is universal. Wherever mental health treatment happens, the tension between safety and autonomy exists. Restraint — whether physical, chemical, or environmental — is sometimes framed as necessary, but the evidence on its psychological impact, especially for trauma survivors, is hard to ignore. For those of us navigating mental health systems elsewhere, this consultation offers a useful lens: What does your region's guidance actually say? What protections are written into the code, and what's left to chance? These are questions worth asking of any institution where vulnerability meets institutional power.
A parallel shift worth noting
Interestingly, while policy frameworks are being reconsidered in Scotland, the broader conversation about mental health treatment is also expanding in other directions. Recent coverage in National Geographic explores metabolic psychiatry — the idea that brain energy metabolism, not just neurotransmitter balance, plays a role in conditions like bipolar disorder and schizophrenia. Early research into ketogenic diets for psychiatric symptoms is gaining traction, with patients and researchers reporting promising, if still preliminary, results. It's a reminder that the landscape of mental health care is shifting on multiple fronts simultaneously — from how we protect rights within institutions to how we rethink the biology of treatment itself.
As the Scottish consultation unfolds, we can watch for how practitioners, patients, and advocacy organisations respond. The proposals are open to anyone with a stake in mental health care — patients, families, carers, and clinicians alike. If there's one small habit worth anchoring today, it's this: before any treatment decision, ask what rights and safeguards are explicitly in place. Not as an act of defiance, but as an act of self-advocacy. Knowing the framework you're operating within is the first step to navigating it with clarity.