Mind responds to CQC’s Monitoring the Mental Health Act report
The Care Quality Commission (CQC) has today published its annual ‘Monitoring the Mental Health Act’ report, which provides an overview of the key trends and issues in mental health hospital inpatient care from 2024-25.
The report’s main findings include:
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Too many people continue to be sent far from home for treatment, with out-of-area placements rising despite a national commitment to end the practice by 2021. In some cases, children are also being placed on adult wards due to a lack of available beds.
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People living in deprived areas are 3.6 times more likely to be detained for treatment under the Mental Health Act compared with those in the least deprived areas.
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Black people are detained at 4 times the rate of white people. In the majority of services the CQC visited (51%) staff had not received training about racial inequalities.
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Longstanding issues with staffing persist, with nearly 1 in 10 roles in NHS mental health trusts unfilled. Reliance on agency staff is impacting people’s recoveries and nearly half (45%) of all Mental Health Act related complaints were about the attitude of staff.
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Although some wards are clean, tidy, and designed in a way that supports people’s needs, some patients describe noisy, dirty, and loud environments, with one describing “blood on the walls” and a “disgusting” toilet. Some struggled with access to basic amenities like food, drink and toiletries.
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During 103 visits last year, inspectors found that at three quarters of trusts’ staff had not heard of the Patient and Carer Race Equality Framework (PCREF) – a mandatory anti-racism framework.
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Between 2023-24 and 2024-25 the average number of restrictive interventions each month rose by 24% – despite the CQC being clear that everyone working in health and care has a role to play in reducing their use. Restrictions include physical, chemical or mechanical through the use of belts and other restraints, and seclusion.
Gemma Byrne, Policy and Influencing Manager at Mind, said:
“These findings deliver a damning verdict on the state of mental health inpatient care. Issues like understaffing, racial inequality and unsafe wards have taken root to the point that unequal and unsafe care have become normalised. How can we expect people with mental health problems to recover in such unfit environments that some report not even being given toothpaste or toilet roll?
“Today’s report shows a continued downward trend in the quality of mental healthcare and people’s outcomes. This is unacceptable for both people with mental health problems at their lowest point, and the many staff who are trying their very best to deliver compassionate care in the most challenging environments.
“Where positive progress is made through initiatives like the Patient Carer Race Equality Framework, it is then lost because as many as three quarters of staff aren’t even aware of its existence.
“Holding a mirror up to reveal the reality of mental health care can only go so far – meaningful change requires decision makers to do more than acknowledge how broken things are. Last year a series of urgent investigations into mental health inpatient care concluded, but we’re yet to hear how the UK government is actioning their findings. And the reformed Mental Health Act is a key milestone for campaigners who have been sounding the alarm for years, but could have gone much further in addressing glaring racial disparities and strengthening the rights of young people. We are ready to continue to work with the UK government and health leaders to tackle these issues and make sure the tools available to make meaningful change are embedded across the system.”
