The health and social care watchdog is to launch an investigation after government figures revealed the number of detentions for mental health treatment had risen to its highest level in at least a decade.
Patients were detained in England for treatment under the provisions of the Mental Health Act 63,622 times in the year to April 2016, the statistics from NHS Digital showed, a rise of 47% since 2006, the year comparable records began, when there were 43,361 detentions.
Dr Paul Lelliott, the deputy chief inspector of hospitals and lead for mental health at the Care Quality Commission, said the figures were concerning, particularly given a national commitment to reduce the number of mental health detentions.
“The causes of the rise in the use of the act are likely to be complex, but the increase in detentions needs to be examined carefully,” he said. “We do not know, for example, the extent to which the rise is due to repeated detentions, it could signal a lack of support in the community for people with serious mental health problems or if people are being detained repeatedly, it could be a sign that some services are operating ‘revolving door’ admissions.
“To get to the bottom of this, we are launching an investigation into the reasons why detentions under the Mental Health Act in England continue to rise. We expect to publish our findings from this next year.”
Much of the rise in detentions came recently, with a 31% increase in the past five years, the statistics showed. Detentions under section two of the Mental Health Act, which allows for people to be held against their will for up to 28 days for diagnosis and treatment, were up 36% over that period. Detentions under section three, which allows for patients to be held for up to six months of compulsory treatment, were up 7%.
A snapshot figure, taken on 31 March, found 20,151 people were being detained under the act, 30% of whom were being held in private hospitals.
Peter Kinderman, the president of the British Psychology Society, said the figures were “tragic and shocking, but not terribly surprising”. Cuts to health budgets, combined with widening inequality, social turmoil and economic austerity were leading to an ever tighter squeeze on the poor, he said.
“If there are pressures on the service from cutting community support, various forms of psychotherapeutic support or social support for people, you could see how the pressures would build up and the people who are on the edge of coping might be pushed into feeling as if there was no support for them and feeling as if they might want to take their own lives,” said Kinderman.
“It doesn’t take much of a threat to social support for people in crisis for them to feel like there’s no point in carrying on living, and at that point you need to step in and take quite drastic action to help them.”
Marjorie Wallace, the chief executive of the mental health charity Sane, speculated that the rise could be the result of situations where patients or their doctors felt detention was the only way to get proper mental health treatment. “We know that community mental health services are overstretched and in many cases unable to provide the early treatment that could prevent people becoming so desperately ill,” she said.
“Moreover, without available local psychiatric beds, doctors are being forced to use the act in order to obtain an inpatient bed for treatment, which may involve sending patients to unfamiliar hospitals where they cannot be easily visited by professionals they know, let alone their friends and family. It is a scandal that you have to be sectioned in order to get treatment. What we need is more rather than fewer beds, so that those who need sanctuary and healing can receive help without having to be deprived of their liberty.”
A Department of Health spokesperson said: “People with mental illness need the best possible care and local areas are investing £693m more to make sure the right services are in place. Decisions about detention under the Mental Health Act are clinically led but the Care Quality Commission will be looking into the rise in cases.”
CQC to investigate as mental health detentions hit 10-year high
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