Policy watch: a steady erosion of rights
| Published date | 24 May 2013 |
| Pages | 60-63 |
| Date | 24 May 2013 |
| DOI | https://doi.org/10.1108/20428301311330090 |
| Author | Sophie Corlett |
| Subject Matter | Health & social care |
Policy watch: a steady erosion of rights
Sophie Corlett
Sophie Corlett is based at
Mind, Stratford, UK.
Abstract
Purpose – The Policy Watch series reflects on recent and forthcoming developments in mental health
policy across the UK. This paper aims to review recent trends in detention under the Mental Health Act 1983
in England and the relationship to trends in access to mental health services.
Design/methodology/approach – The paper reviews recent trends based on research sources and
the findings of the Care Quality Commission, which monitors the Mental Health Act and regulates health
and social care in England.
Findings – The paper suggests that a steady increase in coercion is related to tightening access to
mental health care and that these form a toxic relationship that undermines people’s mental health, recovery
and rights. These trends might be reversed by a combination of rights-based measures, shared
decision-making and commissioning a better level and mix of mental health services.
Originality/value – The paper updates and discusses knowledge on trends and cites recent evidence from
the Care Quality Commission and from Mind.
Keywords Mental health policy, Mental Health Act, Crisis care, Involuntary admission,
Mental health services, Care Quality Commission, Public policy, Mental illness, United Kingdom
Paper type Viewpoint
A steady erosion of rights
In England we are seeing a trend of increased coercion in mental health services. There has
been a steady increase in detentions under the Mental Health Act in recent years reaching
48,631 detentions during 2011-2012, an increase of 10 per cent in the four years since
2007-2008 (Health and Social Care Information Centre, 2012).
Tothis we should add the 4,220 uses of community treatment orders in 2011-2012 (Health and
Social Care Information Centre, 2012). When community treatment orders were introduced
we were led to believe that they would reduce the number of detentions. But this has not
proved to be the case. And we find that the use of community treatment orders too has climbed,
for although people are being discharged from them, this is happening more slowly than
people are going on them. While there are mixed experiences of being on community treatment
orders, we know that people are raising fears about ever coming off an order (Care Quality
Commission, 2013).
This coercive trend does not just affect people who are under the Mental Health Act. There are
now increasingly restrictive regimes in some hospitals for people who are not formally detained.
The Care Quality Commission’s latest Mental Health Act Monitoring Report (Care Quality
Commission, 2013) raises concerns about voluntary patients being detained in all but name
because of locked wards, lack of signage about how to leave the ward and staff preventing
people from leaving. The report also provides examples of people being locked out of their
rooms during the day,only being able to smoke at set times, and being woken through the night
by being checked on regardless of their risk of self harm. It observed that “it has proved all too
easy for cultures to develop in which blanket rules deny people their basic rights – especially
the right to dignity”.
PAGE 60
j
MENTAL HEALTH AND SOCIAL INCLUSION
j
VOL. 17 NO. 2 2013, pp. 60-63, CEmerald Group Publishing Limited, ISSN 2042-8308 DOI 10.1108/20428301311330090
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