‘No single reason’ for increase in Mental Health Act detentions

There is no single reason why more detentions than ever before are being made under the Mental Health Act, the Care Quality Commission (CQC) has concluded.

In a new report entitled Mental Health Act - The rise in the use of the MHA to detain people in England, the rise in detentions is shown to be down to a range of different factors which can vary across the country. Some of these also indicate that the healthcare system is under considerable strain.

Healthcare professionals can apply to detain people under the Mental Health Act to ensure they receive the treatment, care and support they need in hospitals.

Since this is against the person’s wishes, the law is supposed to be used only when other options have bee considered already.

In the ten year period between 2005/06 and 2015/16, the number of detentions increased from 45,484 to 63,622.

As part of its role in monitoring the use of the Mental Health Act in England, CQC made a commitment to explore what could be causing this trend. It reviewed data, visited specialist mental health services and spoke to patients and representative bodies to gather their views.

The outcome of the review shows that the causes of the rise in rates of detention can be grouped under four main themes: changes in mental health service provision and bed management; demographic and social change; legal and policy developments; and data reporting and data quality.

CQC found no evidence that professionals had been misusing the Mental Health Act in any way.

It has shared the briefing with the government to aid its independent review of the Mental Health Act and with commissioners and providers to help them plan and review their services.

Paul Lelliott, deputy chief inspector of hospitals and lead for mental health at the CQC, said: “There is no single reason to explain why detentions continue to rise every year. Population growth, societal changes, better national reporting, duplicate reporting, increased awareness of mental disorder and expanded criteria for detention are all contributing to more and more instances of people being sectioned under the Mental Health Act.

"Some of the factors at play in the rising rates of detention, both nationally and locally, are also signs of a healthcare system under considerable strain. Detentions under the act can be influenced by gaps in support and provision in the system. This includes limited hospital bed availability, which means that people cannot easily be admitted as voluntary patients early in the course of their illness. This is a particular problem if it is coupled with limited support for people in the community, which can prevent a person’s mental disorder from deteriorating to a point that detention under the act is necessary.

"It will take more than changes to primary legislation to tackle this fully and to ensure that people with serious mental health problems always get the safe, high-quality and compassionate care they deserve, when, where and how they need it. Changes to the law must happen alongside action to address the wider problems.”