Mind responds to CQC’s annual Mental Health Act report
The Care Quality Commission has today published its annual report, ‘Monitoring the Mental Health Act’, which looks at how providers are caring for patients nationally.
The Mental Health Act 1983 is the main law under which people in mental health crisis can be held against their will for treatment. It also sets out other community-based powers to enforce treatment plans, including Community Treatment Orders.
As part of its monitoring activity, the CQC interviewed over 4,500 people who were sectioned, as well as relatives and loved ones. Echoing previous years’ reports, today’s analysis highlights long-standing problems around staffing levels, bed capacity and skills shortages – which are all leading to ‘harmful’ gaps in care and treatment.
Key findings include:
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Persistent barriers exist for people from ethnic minority groups and those from deprived areas. Black people are detained under the Mental Health Act at 3.5 times the rate for white people. And people from the most deprived areas are attending A&E for their mental health over 3 times more than people in more well-off areas
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Inappropriate out-of-area placements, where people are sent far away from home from treatment, increased by 25% on the previous year up to 5,500. One mother was sectioned and placed 5 hours away from home from her husband and children, who ‘went to bed crying’ as they were not able to visit her. She described her time under section as ‘isolating, distressing, unsettling and disempowering’
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Too many patients unable to access overstretched community mental health services are getting more unwell and staying in hospital for longer
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Persistent bed shortages can mean some patients are being held in overly restrictive settings. In one facility, a lack of beds on a ward meant seclusion rooms – which are specifically designed, often sparse, unfurnished facilities not appropriate for long term use – were used as bedrooms
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Young people’s experiences continue to be mixed. In nearly half of cases where a child or young person was detained, they had to be re-admitted within a year
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Ward environments are often of poor quality and compromising the safety and dignity of both patients and staff
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Patients are not being supported to fully understand their rights and care plans.
Dr Sarah Hughes, CEO of Mind, said:
“Today’s report makes for heartbreaking reading for people with the most severe mental health problems and their loved ones. The testimony of people who have been sectioned under the Mental Health Act, in too many cases, describes a system which is light years away from delivering not just effective, but compassionate care.
“Fundamental problems with the very basics of safe care, like adequate staffing levels, bed capacity and run-down hospitals, are severely impacting people’s ability to properly recover. Being sent hundreds of miles away from your family and loved ones, and not even being able to contact them due to facility issues, would be difficult enough at the best of times, let alone when you’re experiencing a mental health crisis. Isolating people in this way, and holding them in crumbling, outdated facilities, is the very opposite of dignified, humane care. In some cases, people with mental health problems can’t even get outside to a monitored courtyard for fresh air due to such low staffing levels.
“It is positive to see an emphasis from the Care Quality Commission on the critical opportunity presented by the Mental Health Bill, to strengthen people’s rights when they are at their most unwell. But in isolation, legislative change is not enough – it must go hand in hand with proper resourcing for community care, workforce and estates. With the announcement to abolish NHS England, it’s even more critical that the UK government grasps the scale of the crisis and acts to raise the standard of mental health hospitals.”
