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Mental health services must improve the care they provide to patients

30 January 2013

Mental health services must do more to ensure that the care they provide to patients in hospitals is based on individual needs.

Our Mental Health Act Annual Report, published today, reveals that 15 per cent of people receiving care under the Act are not being involved in the decisions made about their care.

The Act is the law under which a person with a mental disorder may be detained and treated in hospital against their wishes or treated in their community under a community treatment order (CTO).

People who need treatment in hospital for their mental health should have care and support to help them recover.

David Behan, Chief Executive, CQC

Our visits to people who are detained or on CTOs are carried out by Mental Health Act (MHA) commissioners. They check that patients’ basic human rights are being supported during their care and treatment under the Act.

During one visit, the commissioner discovered that none of the patients interviewed knew what was in their care plan. None of the patients felt involved in planning their care or in any decisions about their treatment.

In addition, some patients did not have any information about being discharged from hospital, including what they had to do to prove they could be discharged. Two of the patients that our commissioners spoke to did not even know they were detained or what they had done to warrant being subject to the Act.

Commissioners have, however, seen examples of hospitals that provide good care and treatment to patients who are detained under the Act. Download the full report below for more information.

Other key findings

The number of people subject to the Act is rising. Throughout 2011/12, there were  48,631 detentions (up five per cent) and another 4,220 CTOs were issued (up 10 percent).

Services are also under increasing pressure, especially in regards to the provision of Approved Mental Health Professionals who contribute to decisions about the detention of patients under the Act. Other areas showing evidence of pressure on services are transport to hospital wards, the increased demand for beds, increased workloads and access to psychological therapies.

Our MHA commissioners are also concerned about cultures of control and containment that are enforced over all detained patients. These kinds of rules can become institutionalised and carry the risk of stripping patients of their autonomy and dignity.

David Behan, Chief Executive of CQC, says, “People who need treatment in hospital for their mental health should have care and support to help them recover.

“Some hospitals are doing a very good job in treating people with dignity and respect – so we know it’s possible.  However CQC is concerned that some hospitals have allowed cultures to develop where control and containment are prioritised over treatment and care.

“We will be making mental health a high priority this year and the information gained through our Mental Health Act visits and from other strategic partners will direct our inspection work. Where we witness poor and unacceptable care we will use all the powers that we have to ensure that these practices change.”