scholarly journals Changing patterns in the use of the Mental Health Act 1983 in England, 1984–1996

2000 ◽  
Vol 176 (5) ◽  
pp. 479-484 ◽  
Author(s):  
Matthew Hotopf ◽  
Sharon Wall ◽  
Alec Buchanan ◽  
Simon Wessely ◽  
Rachel Churchill

BackgroundThe Mental Health Act 1983 (MHA) is due to be revised by Parliament in the near future.AimsTo explore changes in the use of the Act since its introduction.MethodThe Department of Health and the Home Office routinely collect data on the numbers of patients admitted to psychiatric hospitals under the MHA. We present absolute figures, by year, for the total numbers admitted under each section of the Act. We used the total psychiatric hospital admissions and total prison populations as denominator data.ResultsFormal admissions rose from 16 044 in 1984 to 26 308 in 1996, a 63% increase. Admissions under the MHA have increased as a proportion of all admissions. The increase is mainly accounted for by changes in the use of Part II of the Act, in particular sections 2 and 3. The use of forensic sections (Part III) has also increased, with a marked increase of sections 47 and 48. Use of Part X of the Act (sections 135 and 136) declined in the late 1980s but rose again in the 1990s.ConclusionsFormal admissions are more common than they were in 1984, despite there being fewer psychiatric beds. This is probably due to changes in the provision of psychiatric services, and changing societal pressures on psychiatrists away from libertarianism and towards coercion.

2019 ◽  
Vol 59 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Simon A Hill ◽  
Elliott Riordan-Eva ◽  
Alexandra Hosking

This paper uses data produced by the Ministry of Justice to look for trends in the numbers of various categories of patients detained under the Mental Health Act in England and Wales between 2003 and 2016. Specifically, we have focussed on patients detained with Ministry of Justice restrictions in place. The number of ‘restricted’ patients, who are largely detained in secure psychiatric hospitals, has risen substantially during this period. If this trend continues, there will be the need for further expansion of secure psychiatric beds in the years ahead. Factors driving the increased number of restricted patients are discussed in this paper.


1994 ◽  
Vol 18 (1) ◽  
pp. 36-38 ◽  
Author(s):  
Marinus P. Klijnsma ◽  
Annie E.A. Bartlett ◽  
Andrea Cohen

The limited previous research on usage of section 136 of the Mental Health Act 1983 (MHA) has either confined itself to description of socio-demographic and clinical data (Dunn ft Fahy, 1990) or considered procedural issues solely in urban areas (Rogers ft Faulkner, 1987). This is despite the repeated concern of the Mental Health Act Commission (1991), which has noted more widespread difficulties in the use of section 136, highlighting individual failures by local services to adhere to the Code of Practice MHA (Department of Health and Welsh Office, 1990). This study attempts a region-wide survey of section 136 agreements and the corresponding frequency of use of the procedures. This is in line with the Reed Committee recommendations (Department of Health/Home Office, 1992), which prioritised early diversion from custody as an area of research, and emphasised the desirability of multi-agency section 136 agreements.


2003 ◽  
Vol 43 (1) ◽  
pp. 75-79 ◽  
Author(s):  
Neil Greenberg ◽  
Niki Haines

Section 136 of the Mental Health Act 1983 is used by police officers to detain persons who they feel might be suffering with mental disorder until a formal Mental Health Act assessment can be undertaken. Previous studies have shown that the outcomes of these assessments result in remarkably different rates of subsequent hospital admissions. Within a rural setting it has also been shown that the rate of use of Section 136 varies considerably. This study examines the use of Section 136 within a family of eight police forces that have been matched to ensure that they cover similar populations. The results show that there are considerable variations in the use of Section 136, with the Devon and Cornwall region using the section over two and a half times the mean for the group. Possible reasons for this discrepancy are discussed.


2002 ◽  
Vol 26 (7) ◽  
pp. 246-247 ◽  
Author(s):  
J. M. Atkinson ◽  
H. C. Garner

Proposals for new mental health legislation make the case for using the ‘least restrictive alternative’ (Scottish Executive, 2001) and the ‘least restrictive environment’ (Department of Health & Home Office, 2000) as guiding principles in deciding the management and treatment of the patient. This appears to be the case made for introducing compulsory treatment in the community. The patient living in the community, while maintained on medication, rather than the hospital would appear to be defined as on the ‘least restrictive alternative’. This, however, takes only a limited approach to what is ‘restrictive’, which should be interpreted more widely, including the patient's view as well as that of clinicians and policy makers. Thus, a patient may see it as less restrictive during an acute phase to be in hospital and not on medication, than in the community but on medication. It is likely, given our knowledge of patients' attitudes to medication (Eastwood & Pugh, 1997), that many patients will prefer to be on oral medication rather than depot, which they see as less restrictive.


1995 ◽  
Vol 19 (2) ◽  
pp. 106-107
Author(s):  
Rosemary Lethem

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).


Author(s):  
Ian Cummins

When Theresa May became Prime Minister in July 2016, she made a speech on the steps of Downing Street in which she outlined a series of ‘burning injustices’ her administration would seek to tackle. Many were struck by the irony of this commitment to tackling inequality and disadvantages coming, as it did, from a senior member of the coalition and Conservative governments that since 2010 had introduced a series of policies which had targeted those living in poverty and the most vulnerable. The scandals of the revelation of the real impact of the ‘hostile environment’ created by May’s Home Office and the appalling treatment of the Windrush generation lay ahead. In May 2017, May announced that a review would be undertaken of the ‘flawed’ Mental Health Act (MHA). In making the announcement she stated:...


2010 ◽  
Vol 16 (4) ◽  
pp. 6
Author(s):  
M Y H Moosa ◽  
F Y Jeenah

<p><strong>Aim.</strong> To review applications for involuntary admissions made to the Mental Health Review Boards (MHRBs) by institutions in Gauteng.</p><p><strong>Method.</strong> A retrospective review of the register/database of the two review boards in Gauteng for the period January - December 2008. All applications for admissions (involuntary and assisted inpatient) and outpatient care (involuntary and assisted), and periodic reports for continued care (inpatient or outpatient care) were included.</p><p><strong>Results.</strong> During the study period the two MHRBs received a total of 3 803 applications for inpatient care, of which 2 526 were for assisted inpatient care (48.1% regional hospitals, 29.6% specialised psychiatric hospitals, 22.2% tertiary academic hospitals). Of the applications for involuntary inpatient care, 73.1% were from the specialised psychiatric hospitals (65.2% from Sterkfontein Hospital). Applications for outpatient care, treatment and rehabilitation (CTR) numbered 1 226 (92% assisted outpatient CTR). Although the health establishments in northern Gauteng applied for more outpatient CTR compared with those in southern Gauteng (879 v. 347, respectively), the ratios of assisted to involuntary outpatient applications for CTR for each region were similar (approximately 12:1 and 9:1, respectively). The boards received 3 805 periodic reports for prolonged CTR (93.5% inpatient, 6.5% outpatient), in the majority of cases for assisted CTR.</p><p><strong>Conclusion.</strong> The study suggests that in the 4 years since the promulgation of the MHCA in 2004 , there have been significant strides towards implementation of the procedures relating to involuntary admission and CTR by all stakeholders. Differences in levels of implementation by the various stakeholders may result from differences in knowledge, perceptions, attitudes and understanding of their roles and therefore indicate the need for education of mental health care professionals and the public on a massive scale. The Department of Health also needs to invest more funds to improve mental health human resources and infrastructure at all health establishments.</p>


1996 ◽  
Vol 20 (12) ◽  
pp. 733-735 ◽  
Author(s):  
Christopher Buller ◽  
David Storer ◽  
Rachel Bennett

Detention of general hospital in-patients under Section 5(2) is a rare occurrence. This study of the use of Section 5(2) in general hospitals uncovered a frequent neglect in following the guidelines of The Mental Health Act and The Code of Practice. Surprisingly the conversion rate of Section 5(2) to Section 2 or 3 was similar to that seen in a number of other studies conducted in the quite different setting of large psychiatric hospitals. A number of patient characteristics were identified that appeared to influence whether 5(2)s were converted to an admission Section. Each general hospital needs to develop guidelines to be followed when staff feel that a patient should be detained under Section 5(2) – an example of such a policy is included.


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