Record numbers of people are being detained for mental health treatment, prompting concern that conditions for patients are worsening due to understaffing and a lack of hospital beds.
There were 50,408 cases of people being detained for compulsory treatment under the Mental Health Act in England during 2012-13; the total topped 50,000 for the first time and marked a 12% rise over the previous five years, from 44,093 in 2008-09.
In the most recent period about 34,650 were detained on admission after being sectioned under the act, and another 14,249 after going to a mental hospital on an informal basis.
The Care Quality Commission (CQC, the NHS care watchdog) said in its annual review of mental health services that it was a “serious cause for concern” that so many of those admitted informally for care and treatment, mainly in hospitals, were then detained.
The CQC also criticised procedures which meant that some patients ended up being detained after being told they were simply going for “a cup of tea”, or “for a nice chat”, or “to see a doctor.”
The numbers put on community treatment orders have also risen sharply, from 2,134 in 2008-09 to 4,600 last year.
The regulator additionally criticised the fact that more than three-quarters of wards in mental health hospitals denied patients basic rights by operating blanket rules such as refusing to let them use the internet or a mobile phone, or to smoke or use secure outdoor spaces and communal spaces. Such practices, which also included rigid visiting times and no food outside set meal times, had “no basis in law or national guidance on good practice, and are unacceptable”, the CQC said.
Paul Farmer, chief executive of the mental health charity Mind, said: “That more people are becoming so unwell they need to be formally admitted to hospital suggests failings in services that are supposed to help people manage their mental health problems.” He highlighted “obvious pressures on the system”, including growing bed shortages, lack of staff and too few therapeutic activities for patients.
The chief executive of Rethink Mental Illness, Paul Jenkins, said his group was very concerned that the number of people detained under the Mental Health Act or placed under community treatment orders was rising. “This suggests people aren’t getting the support they need to manage their condition in the community and avoid reaching crisis point.”
The CQC also criticised as inadequate facilities for those with mental health problems and in a crisis. It said patients were left out of drawing up their own care plans. It said it was unacceptable that in one area, 41 young people were detained in police cells, including one aged just 11.
Meanwhile, MPs and peers are launching an inquiry into whether the government commitment to give mental health “parity of esteem” with physical health in the NHS is being implemented.
The six-month inquiry of the all-party parliamentary group on mental health follows concern from senior figures in the field that the pledge has so far proved more rhetoric than reality.
This article first appeared on The Guardian on 29 January, 2014.