Mental Health - January 2010
Number crunching
They’re neither lies nor damned lies. In fact, as
David Hewitt writes, the new Mental Health Act statistics reveal
some interesting, if inconvenient truths.
The government has recently published fresh
statistics on the use of the Mental Health Act. It seems that in
the year to April 2009, nearly 29,000 people were admitted to
hospital compulsorily. That represents a rise of two per cent on
the previous year and nearly six per cent in the last decade. We
also know that section 2 is becoming more popular and section 3
less; that the use of emergency admission under section 4 has more
than halved in the last decade; and that patients detained because
of learning disability make up only an eighth of one per cent of
the total.
For the first time, the statistics include
Supervised Community Treatment (SCT), to which a lot of attention
has been paid in recent months. It seems that the use of SCT
is three times greater than the government predicted, and that has
caused real problems with the consent to treatment provisions in
the Act. But the statistics show another interesting thing, which
has excited little comment.
To be put on SCT, a patient must first be
detained under section 3 (or section 37). Of all section 3
patients, just over a half are male and just under a half are
female. Yet the ratio among community patients is two-thirds to
one-third. SCT was introduced seven months into the relevant
period, of course, so the figures quoted here are for only five
months. Yet they suggest that where male patients are concerned,
disproportionate use is being made of community powers.
More generally, it seems that of 2,134
patients who had been subject to SCT at 31 March, 207 had been
recalled to hospital and 33 discharged, and 143 had had their CTO
revoked (and so became in-patients once again).
The new figures show that around 16,000 people
are detained in hospital on any one day, with three-quarters in the
NHS and a quarter in the independent sector. But that doesn’t
tell the whole story. There has been a dramatic increase in
the number of patients detained in private hospitals, which is up
more than 220 per cent over the decade and fully 42 per cent since
last year. The government says this might be because new facilities
have opened, and also because more independent sector providers are
now returning MHA data. It might also be because the independent
sector is now more popular than ever before.
These are merely statistics, of course. They
tell us how many people were detained but not what their experience
was like. Yet that too has recently been the subject of
controversy, with the Care Quality Commission and the National
Director of Mental Health squaring up to each other publically. At
times, their dispute was like something from Gulliver’s
Travels. Its subject was the Commission’s survey of acute
in-patient mental health services, in which a quarter of
respondents said their care was poor or only fair. The director
said the focus of the story should have been the three-quarters who
said their care was good. And recent figures on the ethnicity of
detained patients have caused some concern as well, not least
because it seems the number of ‘black’ and ‘black British’ patients
detained under the Mental Health Act went up by nearly 10 per
cent in a year.
Whatever they tell us, this year’s figures are
likely to be less interesting than next year’s. They will cover
detentions up to April 2010, which is also, of course, the first 12
months of the Deprivation of Liberty Safeguards. So far, the DoLS
have been significantly under-used, but we’ll have to wait another
year to see whether that’s because of greater interest in the
possibilities offered by the Mental Health Act.
The new statistics can be found
here.
David Hewitt, Partner
Weightmans LLP