Compulsion and race: over-representation and time to act decisively

Date14 January 2020
Published date14 January 2020
DOIhttps://doi.org/10.1108/MHSI-02-2020-063
Pages1-5
AuthorRachel Perkins,Julie Repper
Subject MatterHealth & social care,Mental health,Social inclusion
Rachel Perkins and Julie Repper
Compulsion and race: over-representation and time to act decisively
In October 2019, the latest Mental Health Act statistics were published (NHS Digital, 2019).
Yet again, they make grim reading.
In 20182019 there were 49,988 new detentions under the Mental Health Act 1983 with
15.5 per cent being detained more than once in the year and 4,840 Community Treatment
Orders issued but [] the overall nation al totals will be high er. Not all provider s submitted
data, and some comple ted incomplete dat a(NHS digital, 2019, p. 2).
The 20182019 rate of Mental Health Act detentions represents a 2 per cent increase over
20172018 figures (NHS Digital, 2019). Indeed the figures have risen by at least 2 per cent
each year from 20152016 (see NHS Digital, 2017, 2018). Direct comparisons of numbers
prior to this are not possible because the way in which data are collected has changed, but
what is absolutely c lear is that the rate of de tentions under the Me ntal Health Act has b een
rising inexorably :
Rates of compulsory detentions in psychiatric hospital have more than doubled since 1983, with the
steepest rises in the last decade and late 1980s/early 90s. From 2005-06 to 2015-16, the reported
number of uses of the Mental Health Act to detain people in hospital increased by 40%. (Independent
Review of The Mental Health Act, 2018, p. 49)
These increasingdetention rates strongly suggestthat there is much work to be done to improve
access to, acceptability of, and experienceof mental health services for everyonewho experiences
a mental health crisis. Numerous initiatives have been aimed to extend the range of options
available to peoplein crisis, including sanctuaries, safehavens, crisis houses and crisis cafes:The
NHS England (2019) Long Term Plan commits to increasing the availability of such options and
ensuring that people can get help when theyare in crisis 24h per day. In 2014, the Department of
Health set up localCrisis Care Concordats, designedto facilitate access to care before crisispoint
is reached, improve the quality of crisis care and treatment, and prevent future crisis.Yet despite
this, the data tables associated with the NHS Digital (2019)[1] show that the number of uses of
Sections 135 and 136 Place of safetyorders has risen from 15,050 in 20162017 to 19,023 in
2018/2019. The situation remains similar to that described by the Care Quality Commission
in 2015. They emphasise that, while pockets of good practiceexist, the quality of support people
receive in crisis depends on where you live and when you seek help:
[] too many people in this situation are unable to access the help they need, when they need it, and
are dissatisfied with the help they have been given. (Care Quality Commission, 2015, p. 2)
[] our work has also shown that far too many people in crisis have poor experiences due to service
responses that fail to meet their needs and lack basic respect, warmth and compassion. This is
unsafe, unfair and completely unacceptable. (Care Quality Commission, 2015, p. 4)
Until everyone has somewhere accessible and acceptable to go when they are approaching a crisis a
place where they know they will be treated with understanding, compassion and dignity it seems
unlikely that the rising tide of compulsory detention and treatment can be stemmed.
However, behind these overall rates of detention, gross inequalities can be found.
Known detention rates for men (91.4 per 100,000) are higher than those for women
(83.2 per 100,000) and men are more likely to be subject to Community Treatment Orders
(11.2 per 100,000 compared to 6.1 per 100,000 for women). Detention rates for younger
DOI 10.1108/MHSI-02-2020-063 VOL. 24 NO. 1 2020, pp. 1-5, © Emerald Publishing Limited, ISSN 2042-8308
j
MENTALHEALTH AND SOCIAL INCLUSION
j
PAG E 1
Editorial

To continue reading

Request your trial

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT