Unpaid carers in Scotland continue to be excluded from key decisions about the care of their loved ones, despite years of legislation and strategies meant to strengthen their rights and support, according to a national commission.

While the majority of the 109 health and care practitioners surveyed by the Mental Welfare Commission believe they work well with carers, the 371 carers who shared their experiences report a consistently different experience.

Many carers told the commission they often struggle to be included and respected as partners in care, with challenges in giving and receiving information and being involved in care planning.

The Commission says this is not a resource issue, but an education and culture issue that must be addressed.

It is calling for the Scottish government to strengthen the recently passed Care Reform Act to ensure services are legally required to treat carers as equal partners – and to demonstrate this in practice.

Claire Lamza, Executive Director (nursing) of the Mental Welfare Commission, said:

“Unpaid carers contribute so much, but far too often at a cost to themselves. Our report shows a clear and persistent gap between the aim of including carers and what actually happens day-to-day.”

“We need decisive action to close this gap. The Care Reform (Scotland) Act 2025 must be used to create a clear legal duty for services to involve carers at every stage. This is essential to turn good intentions into real change for the carers supporting their loved ones.”

The Carers (Scotland) Act 2016 was intended to better support carers to continue to care, if they wish to do so, while also allowing them to have their own life.

This includes encouraging carers views to be taken into account and protecting their health and wellbeing.

However, almost a decade after coming into force, many unpaid carers have now told the Commission about the personal toll of caring, including cancelled medical appointments, reduced working hours, social isolation and declining health.  

Nearly 60% of the carers the Commission engaged with reported a lack of one-to-one support, and only a third said they had received support for their own wellbeing – in contrast to the 85% of services which said they either referred onto support or provided it.

One carer told the Commission:

“Being an unpaid carer has affected every aspect of my life. I have never just been able to be in the role of ‘mum’.”

Mental Health Development Officer at Carers Trust Scotland, Amy Marshall, said too many carers are still excluded from every stage of mental health care, despite provisions in the Act being in place to support their involvement.

She said: “Communication often breaks down during transitions, unpaid carers are left uninformed, and tensions around confidentiality create unnecessary barriers.

“The Care Reform Act offers a real opportunity to embed unpaid carers as equal partners in all parts of mental health services and to implement the reforms in a way that prioritises unpaid carers’ own mental health needs and their right to a break.”

The Act, passed earlier this year, will enshrine the right to breaks for carers, and put new duties on local authorities to promote their take up of financial and other support – but it makes no explicit reference to carers being recognised as equal partners in care.

A Scottish government spokesperson said:

“We recognise the invaluable effort made by unpaid carers in Scotland and are committed to supporting their mental health and wellbeing.

“We are investing £88.4m per year in local carer support through local authority Carers Act funding. Through the Care Reform (Scotland) Act 2025, we will establish a right to breaks for carers, to help protect their wellbeing and sustain caring relationships.

“In 2025/26, we have increased voluntary sector short breaks funding by £5m to £13m –  enabling up to 15,000 additional carers to take short breaks from caring.”

 

Read more: Carers are on their knees; Carers charities urge greater transparency in reforms; Millions meant for carers misspent; Strategy to build ‘sustainable future’ for carers

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