scholarly journals Changes in the use of the Mental Health Act 1983 in England 1984/85 to 2015/16

2018 ◽  
Vol 213 (4) ◽  
pp. 595-599 ◽  
Author(s):  
Patrick Keown ◽  
Hannah Murphy ◽  
Dannielle McKenna ◽  
Iain McKinnon
Keyword(s):  
Mental Health ◽  
Risk Management ◽  
National Health Service ◽  
Health Service ◽  
Private Hospital ◽  
Case Finding ◽  
Community Based ◽  
Private Hospitals ◽  
Mental Health Act ◽  
National Archives

BackgroundConcerns have been raised about the increase in the use of involuntary detentions under the Mental Health Act in England over a number of years, and whether this merits consideration of legislative change.AimsTo investigate changes in the rate of detentions under Part II (civil) and Part III (forensic) sections of the Mental Health Act in England between 1984 and 2016.MethodRetrospective analysis of data on involuntary detentions from the National Archives and NHS Digital. Rates per 100 000 population were calculated with percentage changes. The odds of being formally admitted to a National Health Service hospital compared with a private hospital were calculated for each year.ResultsRates of detention have at least trebled since the 1980s and doubled since the 1990s. This has been because of a rise in Part II (civil) sections. Although the overall rate of detentions under Part III (forensic) sections did not rise, transfers from prison increased and detentions by the courts reduced. The odds of being detained in a private hospital increased fivefold.ConclusionsThe move to community-based mental health services in England has paradoxically led to an increase in the number of people being detained in hospital each year, and in particular an inexorable rise in involuntary admissions. This is likely to be partly because of improved case finding with an increased focus on treatment and risk management, and partly because of changes in legislation. An increasing proportion of this government-funded care is being provided by private hospitals.Declaration of interestNone.

Effect of recent changes to the Mental Health Act 1983 on sections and appeals: possible unintended consequences

2011 ◽  
Vol 35 (8) ◽  
pp. 305-307 ◽  
Author(s):  
Tom Walker-Tilley ◽  
Tim Exworthy ◽  
Martin Baggaley ◽  
Laura Wilkinson ◽  
Ramin Nilforooshan
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Unintended Consequences ◽  
Clinical Implications ◽  
Mental Health Act ◽  
Before And After

Aims and methodWe examined the effect on civil sections and the rate of appeals against them of the amendments made to the Mental Health Act 1983 as a result of the Mental Health Act 2007. We gathered data for the year before and after the introduction of these changes.ResultsWe found increased use of Section 2 (56.8% before and 65.8% after (P < 0.001)) and decreased use of Section 3 (39.5% before and 31.2% after (P < 0.001)). The number of appeals against civil sections decreased (697 before and 692 after) but there was an 8.0% increase in the proportion of appeals to mental health tribunals. There was a decrease in admissions under these sections (817 before and 733 after).Clinical implicationsThese changes may be unintended consequences of the new law, resulting in increased workloads for psychiatrists and costs to the National Health Service.

scholarly journals Consultant psychiatrists' views on the supervision register

1998 ◽  
Vol 22 (7) ◽  
pp. 409-411 ◽  
Author(s):  
Francesco L. Lowe-Ponsford ◽  
Paul Wolfson ◽  
James Lindesay
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Response Rate ◽  
Mentally Disordered ◽  
The Public ◽  
Mental Health Act ◽  
One Year ◽  
Do So

A questionnaire on attitudes to the supervision register, about one year after its introduction, was sent to all consultant psychiatrists identified as working in the National Health Service South Thames Region. A response rate of 72.3% was obtained. Half of the respondents felt that the supervision register was not likely to reduce the risk of violence to the public by mentally disordered people and a quarter was unsure. Just over half felt confident in predicting violence, and over half felt that they had been reasonably trained to do so. Most had not changed their practice in admitting or discharging patients, or in the use of the Mental Health Act. There were criticisms of the register, for example: lack of resources needed to implement it, increased paperwork, stigmatisation of patients and the lack of a formal appeal mechanism. Fifty per cent felt the register should be abolished, only 25.5% felt it should not be.

scholarly journals Trends in the administration of electroconvulsive therapy in England

2009 ◽  
Vol 33 (2) ◽  
pp. 61-63 ◽  
Author(s):  
David Bickerton ◽  
Adrian Worrall ◽  
Robert Chaplin
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
Electroconvulsive Therapy ◽  
National Health ◽  
Clinical Implications ◽  
Mental Health Act ◽  
Number Of Patients

Aims and MethodWe measured the use of electroconvulsive therapy (ECT) over 3 months in England in 2006 and compared that with studies from 1999 and 2002. Questionnaires were completed by hospital ECT staff and returned by post with data collected prospectively on ECT use from National Health Service organisations.ResultsTwo-thirds (56 of 76) of the trusts providing ECT at 109 clinics responded. the number of clinics providing ECT and the number of patients receiving ECT has declined. There has been an increase in the proportion of people receiving ECT when detained under the Mental Health Act 1983.Clinical ImplicationsThe number of ECT clinics is likely to continue to decrease and psychiatrists may have decreasing experience of treating patients with ECT.

scholarly journals Advances in psychiatric treatment in primary care

2001 ◽  
Vol 7 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Christopher Dowrick
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
National Health Service ◽  
Health Service ◽  
Health Professionals ◽  
Depressive Disorders ◽  
Mental Health Problems ◽  
Psychiatric Treatment ◽  
Mental Illnesses ◽  
Breaking Work

Following ground-breaking work by Shepherd et al (1966) and, more recently, Goldberg & Huxley (1992), primary care is now recognised as the arena in which most contact occurs between the National Health Service (NHS) and people with mental health problems. General practitioners (GPs) remain the first, and in many cases the only, health professionals involved in the management of a whole range of conditions, from common anxiety and depressive disorders to severe and enduring mental illnesses.

scholarly journals Research productivity of staff in NHS mental health trusts: comparison using the Leiden method

2014 ◽  
Vol 38 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Alex J. Mitchell ◽  
John Gill
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Health Research ◽  
Research Productivity ◽  
Social Care ◽  
Clinical Implications ◽  
Clinical Services ◽  
Health And Social Care

Aims and methodTo examine research productivity of staff working across 57 National Health Service (NHS) mental health trusts in England. We examined research productivity between 2010 and 2012, including funded portfolio studies and all research (funded and unfunded).ResultsAcross 57 trusts there were 1297 National Institute for Health Research (NIHR) studies in 2011/2012, involving 46140 participants and in the same year staff in these trusts published 1334 articles (an average of only 23.4 per trust per annum). After correcting for trust size and budget, the South London and Maudsley NHS Foundation Trust was the most productive. In terms of funded portfolio studies, Manchester Mental Health and Social Care Trust as well as South London and Maudsley NHS Foundation Trust, Oxford Health NHS Foundation Trust and Cambridgeshire and Peterborough NHS Foundation Trust had the strongest performance in 2011/2012.Clinical implicationsTrusts should aim to capitalise on valuable staff resources and expertise and better support and encourage research in the NHS to help improve clinical services.

scholarly journals A longitudinal evaluation of two-year outcome in a community-based mental health service using graphical chain models

2004 ◽  
Vol 13 (1) ◽  
pp. 10-23 ◽  
Author(s):  
Mirella Ruggeri ◽  
Giulia Bisoffi ◽  
Antonio Lasalvia ◽  
Francesco Amaddeo ◽  
Chiara Bonetto ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Community Based ◽  
Longitudinal Evaluation

scholarly journals Commissioning mental health services: role of the consultant psychiatrist

2000 ◽  
Vol 6 (1) ◽  
pp. 73-80 ◽  
Author(s):  
Chris Simpson
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
General Practitioner ◽  
National Health Service ◽  
Health Service ◽  
Health Services ◽  
Consultant Psychiatrist ◽  
Health Authorities ◽  
Care Groups

The current National Health Service (NHS) approach to commissioning health services is in flux. The purchasing of care from providers by general practitioner fundholders (GPFHs) and health authorities has changed with the new White Papers. GPFHs no longer exist and the commissioning role is being handed over from health authorities to primary care groups (PCGs). An understanding of the reasons for change and current arrangements will aid the consultant psychiatrist in influencing this process.

scholarly journals Specialist personality disorder services in England: a case for managed clinical networks?

2005 ◽  
Vol 29 (10) ◽  
pp. 365-368 ◽  
Author(s):  
Kingsley Norton ◽  
Julian Lousada ◽  
Kevin Healy
Keyword(s):  
Mental Health ◽  
National Health Service ◽  
Personality Disorder ◽  
Health Service ◽  
Personality Disorders ◽  
National Health ◽  
Clinical Networks ◽  
Department Of Health ◽  
Specialist Services

Following the publication by the National Institute for Mental Health in England (NIMHE) of Personality Disorder: No Longer A Diagnosis of Exclusion (National Institute for Mental Health in England, 2003), it is perhaps surprising that so soon after there have been threats to the survival of some of the small number of existing specialist personality disorder services to which it refers. Indeed, one of the few in-patient units specialising in such disorders (Webb House in Crewe) closed in July 2004. Such closures or threats argue for closer collaboration in planning between the relevant secondary and tertiary services and also between the Department of Health, the NIMHE and local National Health Service commissioners. Not safeguarding existing tertiary specialist services, at a time of increasing awareness of the needs of patients with personality disorders, may be short-sighted.

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