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Purpose The purpose of this paper is to investigate the use of the Mental Health (Care and Treatment) (Scotland) Act 2003 for people with learning disabilities in Scotland, in the context of the recent commitment by the Scottish Government to review the place of learning disability (LD) within the Act. Design/methodology/approach All current compulsory treatment orders (CTO) including LD as a type of mental disorder were identified and reviewed. Data was collected on duration and type of detention (hospital or community based) for all orders. For those with additional mental illness and/or personality disorder, diagnoses were recorded. For those with LD only, symptoms, severity of LD and treatment were recorded. Findings In total, 11 per cent of CTOs included LD as a type of mental disorder. The majority of these also included mental illness. The duration of detention for people with LD only was almost double that for those without LD. A variety of mental illness diagnoses were represented, psychotic disorders being the most common (54 per cent). Treatment was broad and multidisciplinary. In all, 87 per cent of people with LD only were prescribed psychotropic medication authorised by CTO. Originality/value There has been limited research on the use of mental health legislation for people with learning disabilities. This project aids understanding of current practice and will be of interest to readers both in Scotland and further afield. It will inform the review of LD as a type of mental disorder under Scottish mental health law, including consideration of the need for specific legislation.

Purpose – The purpose of this paper is to describe the unique and independent role of the Mental Welfare Commission for Scotland. Design/methodology/approach – The paper takes the reader through the history of the Commission, its changing status, roles and responsibilities, its influence and impact, and current priorities. It is based on details of the Commission ' s development, narrative from current employees and published investigations and advice. Findings – The Mental Welfare Commission has advanced significantly since its original establishment. It plays a vital role in protecting the human rights of people in Scotland with learning disabilities and mental illness, by visiting those who are in receipt of care or treatment, investigating situations of concern, providing advice and guidance, monitoring the Mental Health (Care and Treatment) (Scotland) Act 2003 and Adults with Incapacity (Scotland) Act 2000 and shaping relevant policy and legislation. Originality/value – This paper provides an introduction to the work of the Commission, which will be of value to readers in Scotland and beyond. It illustrates its importance in preserving the rights of individuals with learning disabilities and mental illness in line with the UN Convention on the Rights of Persons with Disabilities and other legislation.

Background Autism is a neurodevelopmental condition, characterized by differences in social communication and social interaction as well as restricted interests and repetitive behaviours ( American Psychiatric Association, 2013 ). Research has suggested that 50% of adults with autism meet criteria for an anxiety disorder diagnosis ( Russell et al., 2013 ). Despite a call for multidisciplinary insights ( White et al., 2018 ), few studies have included perspectives of practitioners in this field. Method We conducted interviews with eight practitioners (6 Clinical Psychologists, 1 Consultant Clinical Psychologist and 1 Nurse Practitioner) who work with adults with autism and anxiety on a regular basis. Results Via thematic analysis, four key themes were identified: 1. Modifications to psychological therapy 2. Thinking outside the box 3. Continued support 4. Issues with anxiety measures. Conclusion Modification of standard anxiety interventions are common in practice but the course and nature of these modifications are inconsistent and may depend on practitioner experience. Practitioners may consistently have to think inventively in order to best serve adults with autism and anxiety. Current anxiety measures could be improved in order to accurately gauge anxiety, specific to adults with autism. These findings are discussed in relation to practice and future research.