Referrals and outcomes of assessment for compulsory admission under the mental health act 1983 in Norfolk, England

2017 ◽  
Vol 41 (S1) ◽  
pp. S353-S353
Author(s):  
J.N. Beezhold ◽  
D. Fothergill ◽  
L. Jervis ◽  
G. Mosa ◽  
A. Pandey ◽  
...  
Keyword(s):  
Mental Health ◽  
Observational Study ◽  
Social Services ◽  
Living Alone ◽  
Compulsory Admission ◽  
Total Patient ◽  
Admission Rates ◽  
Mental Health Act ◽  
Competing Interest ◽  
Published Research

IntroductionA significant number of people are not detained in hospital following assessment under the Mental Health Act 1983 (MHA) for possible detention. However, since amendments in 2007, some studies show an increase in total patient detentions. There is currently a lack of published research describing both outcomes and their affecting variables.ObjectivesTo determine rates, outcomes and affecting variables of MHA assessments in Norfolk, 2001–2011.MethodsThis observational study involved data collection from all 11,509 referrals for detention assessment under the MHA. Data was collected by Norfolk Social Services from 2001–2011 including age, gender and marital status.ResultsFollowing assessment, 6903 (60.0%) were admitted; of those, 1157 (16.8%) were voluntary and 5746 (83.2%) were detained; 4606 (40%) were not admitted. Admission rates for males (50.4%) and females (49.5%) were similar. Detention rates increased with age: 37.6% of < 18s; 47.1% of 18–64s and 61.4% of 65+. A greater proportion of married (57.5%) and widowed patients (58.2%) were detained, compared with patients who were single (48%). Accommodation status showed 52% of those living with other were detained versus 43.9% of those with no fixed abode.ConclusionsThe finding that a higher proportion of married than single people, and of those living with others versus living alone, were detained following assessment is unexpected but significant and needs further investigation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Mental Health Act Assessment Process and Risk Factors for Compulsory Admission to Psychiatric Hospital: A Mixed Methods Study

2019 ◽  
Vol 50 (3) ◽  
pp. 642-663 ◽  
Author(s):  
Alice Wickersham ◽  
Shilpa Nairi ◽  
Rebecca Jones ◽  
Brynmor Lloyd-Evans
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Mixed Methods ◽  
Service Evaluation ◽  
Model Potential ◽  
Assessment Process ◽  
Compulsory Admission ◽  
Admission Rates ◽  
Mental Health Act ◽  
Community Team

Abstract Background Compulsory admission rates under the Mental Health Act (MHA) have been on the rise for many years despite representing a costly and coercive approach to psychiatric care. There is therefore an urgent need to minimise compulsory admission rates using interventions based on known risk factors for detention. However, risk factors in the MHA assessment process have been under-researched. Methods A mixed methods service evaluation was conducted in one inner London NHS Trust. A retrospective cohort study used routinely collected assessment records to model potential risk factors for detention. Local assessors were interviewed to explore factors that might help or hinder detention minimisation. Main findings Assessments were less likely to result in detention when professionals other than the assessing team were in attendance, although this association weakened after adjusting for potential confounders. Interviewed assessors identified factors that could contribute to detention minimisation in the assessment process, in general service provision, and in wider society. Conclusion Some local assessment processes could contribute to minimising detention rates, such as community team participation in assessments. Challenges posed by limited resources and community and inpatient care were particularly evident. Consideration of these might also help reduce detentions.

scholarly journals Aftercare: who attends section 117 meetings?

1995 ◽  
Vol 19 (2) ◽  
pp. 106-107
Author(s):  
Rosemary Lethem
Keyword(s):  
Mental Health ◽  
Nursing Home ◽  
Patient Care ◽  
Social Services ◽  
Local Health ◽  
Hospital Department ◽  
Health And Social Services ◽  
Mental Health Act ◽  
Department Of Health ◽  
Legal Duty

The purpose of aftercare is to enable patients to return to their home or accommodation other than a hospital or nursing home, and to minimse the need for future in-patient care. Under section 117 of the Mental Health Act 1983, local health and social services authorities have a legal duty to provide aftercare for certain categories of patients when they leave hospital (Department of Health and Welsh Office, 1993).

The law

2009 ◽  
pp. 459-498
Keyword(s):  
Mental Health ◽  
Human Rights ◽  
Compulsory Admission ◽  
Sexual Offences ◽  
Disability Discrimination ◽  
Mental Health Act ◽  
Assessment And Treatment ◽  
Human Rights Act ◽  
Disability Discrimination Act ◽  
Health Review

Mental Health Act 1983 460 Mental Health Act 2007 462 Compulsory admission to hospital for assessment and treatment 464 Emergency holding powers 466 Mental Health Review Tribunals 468 The Mental Health Act Commission 470 Sexual Offences Act 472 Disability Discrimination Act 2005 474 Human Rights Act ...

scholarly journals The Commission for Health Improvement (CHI) review of North Birmingham Mental Health Trust: What can we hope for from the CHI?

2002 ◽  
Vol 180 (1) ◽  
pp. 6-7 ◽  
Author(s):  
Tom Burns
Keyword(s):  
Mental Health ◽  
Social Services ◽  
Health Improvement ◽  
Multidisciplinary Teams ◽  
Health Advisory ◽  
Advisory Service ◽  
Mental Health Act ◽  
Audit Commission ◽  
Health Trust

If you are working in mental health, you get used to being inspected and commented upon – the Mental Health Act Commission, Audit Commission, Social Services Inspectorate, Health Advisory Service (HAS, as was) and public inquiries into patient homicides. Working in multidisciplinary teams has made us used to operating with a variety of perspectives and for most of us this is a necessary and welcome part of the job. Few psychiatrists, however, are so sanguine about the former HAS or about homicide inquiries. The repeated complaint has been their inconsistency. Their quality and tone (potentially as damaging as their findings) have varied to quite an indefensible degree.

Preserving Control: Understanding People's Experiences Before, During and After Detention Under the Irish Mental Health Act 2001

2016 ◽  
Vol 33 (S1) ◽  
pp. S483-S483
Author(s):  
D. McGuinness ◽  
A. Higgins ◽  
B. Hallahan ◽  
E. Bainbridge ◽  
C. McDonald ◽  
...  
Keyword(s):  
Mental Health ◽  
Subjective Experience ◽  
Structured Interview ◽  
Legal Framework ◽  
Theoretical Understanding ◽  
Mental Health Act ◽  
Loss Of Autonomy ◽  
Psychiatric Units ◽  
The Face ◽  
Competing Interest

IntroductionThe Mental Health Act 2001 provides a legal framework for the involuntary admission and treatment of individuals deemed to have a mental disorder to psychiatric units. The perspectives of people who have been detained are relatively poorly understood.ObjectiveTo develop a theoretical understanding of individual's experiences throughout the trajectory of their detention and to understand the psychological and social processes that individuals use to cope before, during and after detention.MethodsFifty individuals subject to detention across three psychiatric units consented to be interviewed three months after their detention. Using a semi-structured interview people recounted their experiences. Interviews were analysed using the principles underpinning Grounded Theory.ResultsThe theory ‘Preserving Control’ encapsulates individuals’ experiences and consists of three related themes: ‘Losing Control’, ‘Regaining Control’ and ‘Maintaining Control’. ‘Losing Control’ describes individuals’ experiences of losing their autonomy and liberty thought the process of detention and hospitalisation. ‘Regaining Control describes, the strategies individuals used in an attempted to restore their loss of autonomy and control. ‘Maintaining Control’ describes how individuals lived with the consequences of detention and contended with impact on discharge.ConclusionsWhilst a large variation existed in relation to the subjective experience of being detained, the characteristic process that individuals tend to experience related to identifiable phases of preserving control in the face of this loss of autonomy. Findings from this study highlight the importance of more sensitive interactions support and information during and after the detention process.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Comparative Study Between Preferential Consultations And Most Common Diagnoses

2016 ◽  
Vol 33 (S1) ◽  
pp. S451-S451
Author(s):  
C. Manso Bazús ◽  
J. Valdes Valdazo ◽  
E. Garcia Fernandez ◽  
L.T. Velilla Diez ◽  
J. Min Kim ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Observational Study ◽  
Affective Disorders ◽  
Primary Care Physicians ◽  
The Other ◽  
Health Care Burden ◽  
Competing Interest ◽  
The One

IntroductionTo the specialized attention arrives as preferred patients with minor diagnosis.ObjectiveWe do a relation between the type (normal/preferential) derivation of the first consultations and their corresponding diagnosis.MethodologyRetrospective observational study with data gathered during 3 months, which handle 2 variables: on the one hand, type of derivation and on the other, effected diagnosis.ResultsThe most frequent diagnosis found are adaptative disorders and affective disorders, corresponding to 45.45% and 9.1%, respectively of preferred leads.ConclusionsAlmost half of preferential queries (consultations) could be treated in first instance by primary care physicians releasing mental health care burden.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals The impact of COVID-19 on an inpatient mother and baby unit: a service evaluation

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S316-S316
Author(s):  
Joanna Cranshaw ◽  
Gertrude Seneviratne ◽  
Ranga Rao ◽  
Julia Ogunmuyiwa ◽  
Rebecca McMillin ◽  
...  
Keyword(s):  
Mental Health ◽  
Length Of Stay ◽  
Social Services ◽  
Unit Length ◽  
Perinatal Period ◽  
Service Evaluation ◽  
Psychotic Illness ◽  
Mental Health Act ◽  
Mother And Baby Unit ◽  
The Impact

AimsUnique challenges have been faced by women in the perinatal period during the COVID-19 pandemic and the impact of this is compounded for women suffering from mental illness. This service evaluation looked at different aspects of the treatment pathway on a specialist inpatient psychiatric Mother and Baby Unit during the pandemic to identify what changes occurred.MethodData were collected for all admissions to the unit between January 2019 and October 2020, with the beginning of the pandemic being defined as on or after 1st March 2020. Information was collected retrospectively from electronic clinical notes on ethnicity, length of stay, diagnosis, mental health act use and restrictive practice, medication, psychology, occupational therapy and social services involvement.ResultThere were 114 admissions to the MBU during the study period. 4 were parenting assessments rather than acute psychiatric admissions and were excluded from the analysis, giving a sample of 110 women. 58% (62/110) were classed as “pre-pandemic” and 43.6% (48/110) were “during pandemic”. 95.45% (105/110) of women were postpartum 4.55% (5/110) were pregnant. Mean length of stay was shorter during the pandemic at 44 days, compared to 61 pre-pandemic. There was greater use of the mental health act during the pandemic: only 43.75% of patients were informal throughout admission, compared to 70.97% pre-pandemic. Mean duration of detention was shorter at 25 days (32 pre-pandemic). Psychotic illness made up a greater proportion of diagnoses during the pandemic: 56% (27/48) compared to 44% (27/62) pre-pandemic. The next most common diagnostic group was mood and anxiety disorders, which made up 29% (14/48) of diagnoses during the pandemic, but 43% (27/62) pre-pandemic. Outcomes as measured using the Health of the Nation Outcome Scale showed a mean improvement between admission and discharge of 6.65, compared to 5.15 pre-pandemic. HONOS scores were higher on admission during the pandemic (12.83, vs 10.88), suggesting a higher level of acuity.ConclusionDuring the COVID-19 pandemic on this Mother and Baby Unit, length of stay was shorter, a greater proportion of patients were detained under the mental health act (although length of detention was shorter) and psychotic illness was more prevalent. This study demonstrates that there were differences in this perinatal inpatient population during the pandemic and this may be a reflection on the wider impact of COVID-19 on perinatal mental health.

scholarly journals A survey of psychiatrists' views of the use of the Children Act and the Mental Health Act in children and adolescents with mental health problems

2001 ◽  
Vol 25 (8) ◽  
pp. 304-306 ◽  
Author(s):  
Alex Mears ◽  
Adrian Worrall
Keyword(s):  
Mental Health ◽  
Children And Adolescents ◽  
Social Services ◽  
Mental Health Problems ◽  
Health Problems ◽  
Children And Young People ◽  
Project Report ◽  
Mental Health Act ◽  
Department Of Health ◽  
Consent To Treatment

Aims and MethodTo identify psychiatrists' concerns relating to the use of legislation in children and young people with mental health problems. Four hundred and eighty members of the child and adolescent faculty of the Royal College of Psychiatrists were asked to list their main concerns.ResultsTwo hundred and fifty-eight members responded. The four most reported themes were: choosing between the Mental Health Act and the Children Act; general issues around consent to treatment; issues with social services departments; and the stigma associated with using the Mental Health Act.Clinical ImplicationsThe range of themes identified from this survey have served to focus the evaluation of the use of the Children Act and the Mental Health Act in Children and Adolescents in Psychiatric Settings (CAMHA-CAPS), and informed the design of subsequent data collection tools. The project report has now been submitted to the Department of Health for consideration.

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