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30 Kasım 2016 Çarşamba

CQC to investigate as mental health detentions hit 10-year high

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%.



Marjorie Wallace of Sane


Marjorie Wallace of Sane says doctors are being forced to use the act to obtain an inpatient bed for treatment. Photograph: Richard Saker for the Observer

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

28 Eylül 2016 Çarşamba

Suicide rate hits 10-year high and dementia poised to become leading cause of death

The number of Australians taking their own lives has hit a 10-year high, while dementia is tipped to overtake heart disease as the nation’s leading cause of death within five years.


The number of suicide deaths climbed above 3000 in 2015 for the first time, rising more than 5% in 12 months, official figures show.


Suicide was the leading cause of death for 15-44 year olds, with males three times more likely than females to take their own lives.


Suicide rates were highest in the Northern Territory, while Queensland recorded the greatest increase in deaths.


The Australian Bureau of Statistics found that while suicide accounted for less than 2% of overall deaths in Australia in 2015, it claimed the lives of a third of those aged 15-24 and more than a quarter of 25-34 year olds.


Mental health groups were dismayed by the rising rates and called for a new national approach to suicide prevention.


The chairman of beyondblue, Jeff Kennett, said the Senate should set up a special commission to combat suicide, while Lifeline wants a national summit.


“These figures have to stop us in our tracks,” Kennett said. “The 2015 total is two-and-a-half times the national road toll and six times the number of Australian lives lost in the entire Vietnam War.”


The chief executive of Sane Australia, Jack Heath, said while much had been done to reduce the stigma around mild and moderate mental health issues, more help was needed among the 700,000 Australians with more complex conditions.


“There needs to be access to better-quality services and that particularly becomes an issue for people in rural and regional areas where there are a quarter of the psychiatrists and half the psychologists,” he said.


“And we need to do a better job to help people who are discharged from emergency departments after suicide attempts by making sure there’s better follow-up services.”


While deaths from suicide are rising, heart disease remains the main cause of death for most Australians with more than 19,700 fatalities last year.


However the ABS predicts dementia will topple heart disease from its top spot by 2021, with the number of deaths having doubled in the past decade to 12,625 largely as a result of our ageing population.


Dementia is now the second-biggest killer of Australians, while heart disease and stroke-related deaths have been steadily declining.


Alzheimer’s Australia’s CEO, Maree McCabe, said while one in 13 people in their 30s, 40s and 50s have the brain disorder there was not enough awareness about dementia among young and middle-aged people, who often mistakenly think dementia is a normal part of ageing.


“If we can delay the onset of dementia by five years we would reduce the number of people who get dementia by 30%,” she said.


McCabe called for a government-funded national dementia strategy, similar to those in the US and Britain.


She also advises people reduce their risk of developing dementia by exercising, eating healthily, socialising and keeping their brains active.


Leading causes of death in Australian in 2015


* Ischaemic heart diseases (19,777, down from 21,721 in 2010)


* Dementia, including Alzheimer’s disease (12,625, up from 9003)


* Cerebrovascular diseases (10,869, down from 11,200)


* Trachea, bronchus and lung cancer (8466, up from 8102)


* Chronic lower respiratory diseases (7991, up from 6129)


* Diabetes (4662, up from 3948)


Source: ABS (excludes suicide)


Crisis support services can be reached 24 hours a day: Lifeline 13 11 14; Suicide Call Back Service 1300 659 467; Kids Helpline 1800 55 1800; MensLine Australia 1300 78 99 78



Suicide rate hits 10-year high and dementia poised to become leading cause of death