BASW urges action in wake of CQC report highlighting concern over detentions under Mental Health Act

BASW warned politicians and service providers to act on a government watchdog report that found the treatment of some people detained under the Mental Health Act in England is a “far cry from the policy vision”.

BASW was responding in the wake of the Care Quality Commission's (CQC) Mental Health Act Annual Report into whether the basic human rights of people detained under the Mental Health Act 1983 are being supported.

The report found evidence of people not being involved in their care, services buckling under pressure and the persistence of a culture where “control and containment are prioritised over the treatment and support of individuals”.

In its summary, the CQC - which visited 1,546 wards between 2011 and 2012 - said although there was some overall improvement, the majority of concerns highlighted in previous reports remain, with issues in care planning, patient involvement and consent to treatment most prevalent.

The report warns: “It is with great regret that CQC notes that there are themes that recur year-on-year and paint a picture of practice in some areas of mental health provision that is a far cry from the policy vision. Yet it is clear from the excellent practice that CQC observes in some providers, that the policy vision is not an unrealistic one.”

England Professional Officer Joe Godden said: “The report highlights many familiar areas of concern: these include serious pressures due to bed shortages, poor alternatives to hospital services and the continued over-representation of black and ethnic minority patients among people detained under the Mental Health Act or subject to community treatment orders.

“Poor care plans for far too many people is stressed yet again by the CQC, as is the continued unacceptable problems preventing Approved Mental Health Professionals (AMHPs) from undertaking their work properly.

“Ministers, care trusts and social service departments need to take the report seriously. It is totally unacceptable that the same issues recur as in previous similar reports, with certain practices actually getting worse.”

Mr Godden also highlighted concern expressed by frontline staff of the “toxicity” of some mental health units and the continued “overuse and inappropriate use of restraint”.

The CQC report found more than one in six people receiving care under the Act did not have a personalised care plan. More than a third (37%) of care plans showed no evidence of the patient’s views been sought.

Almost half (45%) of records reviewed showed no evidence of consent to treatment discussions before the first administration of medication and on one in five visits CQC Commissioners expressed concern over the detention of patients who were voluntary rather than compulsory patients.

The CQC said some wards did a “very good job in treating patients with dignity and respect”, but many services were struggling under increased pressure for beds, transport demands, rising workloads and providing access to psychological therapies.

David Behan, Chief Executive of CQC, said: “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.”

According to Government statistics, mental health disorders now account for nearly a quarter (23%) of the total burden of disease in the UK, compared to 16% each for cancer and heart disease.

The Government in England has made a commitment to creating parity of esteem between mental and physical health services.