Monitoring the Mental Health Act is our annual report on the use of the Mental Health Act (MHA). It looks at how providers are caring for patients, and whether patients' rights are being protected.
Monitoring the Mental Health Act in 2020/21
The report for 2020/21 finds:
1 - The workforce is under extreme pressure
The pandemic has placed additional stresses on staff, patients and carers. Many patients and carers have told us that they appreciate the extra efforts made by staff to mitigate the effects of lockdown restrictions and there has been some good practice. But staff are now exhausted, with high levels of anxiety, stress and burnout, and the workforce is experiencing high levels of vacancies. The negative impact of working under this sustained pressure poses a challenge to the safe, effective and caring management of inpatient services and to the delivery of care in a way that maintains people’s human rights.
2 - Community services are key to reducing levels of detention in hospital
Not getting the right help at the right time can lead to symptoms worsening and people needing inpatient care. During the pandemic this has been a particular concern for children and young people. We have seen an increase in the numbers of children and young people being cared for in inappropriate settings while they wait for an inpatient bed. The Independent Care (Education) and Treatment reviews have also shown the impact of a lack of community care, with people being admitted to hospitals for prolonged periods of time.
3 - Urgent action is needed to address longstanding inequalities in mental health care
We remain concerned that Black or Black British people are more likely to be detained under the MHA, spend longer in hospital and have more subsequent readmissions than White people. Reliable local and national data is key to identifying inequalities in care and measuring progress towards closing these gaps. This needs to be a focus across integrated care systems. We are keen to see the rollout of the patient and carers race equalities framework, a tool to help mental health trusts work with Black and minority ethnic communities to achieve practical change. We recognise that some factors in inequality are broader than health care provision.