Trends in the number of restricted patients in England and Wales 2003–2016: Implications for forensic psychiatry services

2019 ◽  
Vol 59 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Simon A Hill ◽  
Elliott Riordan-Eva ◽  
Alexandra Hosking
Keyword(s):  
Mental Health ◽  
Forensic Psychiatry ◽  
Psychiatric Hospitals ◽  
England And Wales ◽  
Mental Health Act ◽  
Psychiatric Beds

This paper uses data produced by the Ministry of Justice to look for trends in the numbers of various categories of patients detained under the Mental Health Act in England and Wales between 2003 and 2016. Specifically, we have focussed on patients detained with Ministry of Justice restrictions in place. The number of ‘restricted’ patients, who are largely detained in secure psychiatric hospitals, has risen substantially during this period. If this trend continues, there will be the need for further expansion of secure psychiatric beds in the years ahead. Factors driving the increased number of restricted patients are discussed in this paper.

scholarly journals Changing patterns in the use of the Mental Health Act 1983 in England, 1984–1996

2000 ◽  
Vol 176 (5) ◽  
pp. 479-484 ◽  
Author(s):  
Matthew Hotopf ◽  
Sharon Wall ◽  
Alec Buchanan ◽  
Simon Wessely ◽  
Rachel Churchill
Keyword(s):  
Mental Health ◽  
Hospital Admissions ◽  
Psychiatric Hospitals ◽  
Home Office ◽  
Mental Health Act ◽  
Department Of Health ◽  
Changing Patterns ◽  
Prison Populations ◽  
Psychiatric Beds ◽  
Near Future

BackgroundThe Mental Health Act 1983 (MHA) is due to be revised by Parliament in the near future.AimsTo explore changes in the use of the Act since its introduction.MethodThe Department of Health and the Home Office routinely collect data on the numbers of patients admitted to psychiatric hospitals under the MHA. We present absolute figures, by year, for the total numbers admitted under each section of the Act. We used the total psychiatric hospital admissions and total prison populations as denominator data.ResultsFormal admissions rose from 16 044 in 1984 to 26 308 in 1996, a 63% increase. Admissions under the MHA have increased as a proportion of all admissions. The increase is mainly accounted for by changes in the use of Part II of the Act, in particular sections 2 and 3. The use of forensic sections (Part III) has also increased, with a marked increase of sections 47 and 48. Use of Part X of the Act (sections 135 and 136) declined in the late 1980s but rose again in the 1990s.ConclusionsFormal admissions are more common than they were in 1984, despite there being fewer psychiatric beds. This is probably due to changes in the provision of psychiatric services, and changing societal pressures on psychiatrists away from libertarianism and towards coercion.

scholarly journals Rise in the use of section 136 of the Mental Health Act 1983 in England and Wales: A viewpoint on Loughran (2018)

2019 ◽  
Vol 60 (2) ◽  
pp. 140-146 ◽  
Author(s):  
Mark Cresswell
Keyword(s):  
Mental Health ◽  
Recent Work ◽  
Theoretical Perspective ◽  
Causal Analysis ◽  
England And Wales ◽  
Mental Health Act ◽  
The Law

This article provides a critical viewpoint on Loughran’s recent work in Medicine, Science and the Law on the causes of the rise in the police’s use of section 136 (s136) of the Mental Health Act 1983 (Loughran M. Detention under section 136: why is it increasing? Med Sci Law 2018; 58: 268–274). The rate of this rise seems significant: by 2014, it was five times more likely that a person in England would be detained in a hospital under s136 than it was in 2000, and the trend has continued to the present day. This viewpoint considers the significance of the s136 rise from the theoretical perspective of causal analysis.

R v Westwood (Thomas): diminished responsibility and disposals under the Mental Health Act 1983

2021 ◽  
Vol 72 (2) ◽  
Author(s):  
Sean Mennim
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
England And Wales ◽  
Mental Health Act ◽  
Court Of Appeal ◽  
Diminished Responsibility

This is a commentary on R v Westwood (Thomas), where the Court of Appeal of England and Wales held that the judge had erred in assessing Westwood’s ‘retained responsibility’ as medium to high under the Sentencing Council Guideline for manslaughter by reason of diminished responsibility. Although the sentencing judge concluded that the offending was caused by Westwood’s anger, the Court of Appeal found the psychiatric evidence clearly indicated that the most significant factor was Westwood’s mental illness and that his anger at the time of the offence was a manifestation of his mental illness. Westwood’s responsibility was low, and it was appropriate to impose both a hospital and restriction order.  

scholarly journals Repeated Police Mental Health Act Detentions in England and Wales: Trauma and Recurrent Suicidality

2019 ◽  
Vol 16 (23) ◽  
pp. 4786
Author(s):  
Claire Warrington
Keyword(s):  
Mental Health ◽  
Lived Experience ◽  
Mental Health Problems ◽  
Police Intervention ◽  
England And Wales ◽  
Mental Health Act ◽  
Self Harm ◽  
South East England ◽  
National Police

Most police Mental Health Act (Section 136) detentions in England and Wales relate to suicide prevention. Despite attempts to reduce detention rates, numbers have risen almost continually. Although Section 136 has been subject to much academic and public policy scrutiny, the topic of individuals being detained on multiple occasions remains under-researched and thus poorly understood. A mixed methods study combined six in-depth interviews with people who had experienced numerous suicidal crises and police intervention, with detailed police and mental health records. A national police survey provided wider context. Consultants with lived experience of complex mental health problems jointly analysed interviews. Repeated detention is a nationally recognised issue. In South East England, it almost exclusively relates to suicide or self-harm and accounts for a third of all detentions. Females are detained with the highest frequencies. The qualitative accounts revealed complex histories of unresolved trauma that had catastrophically damaged interviewee’s relational foundations, rendering them disenfranchised from services and consigned to relying on police intervention in repeated suicidal crises. A model is proposed that offers a way to conceptualise the phenomenon of repeated detention, highlighting that long-term solutions to sustain change are imperative, as reactive-only responses can perpetuate crisis cycles.

scholarly journals A survey of general hospital in-patients detained under Section 5(2) of the 1983 Mental Health Act

1996 ◽  
Vol 20 (12) ◽  
pp. 733-735 ◽  
Author(s):  
Christopher Buller ◽  
David Storer ◽  
Rachel Bennett
Keyword(s):  
Mental Health ◽  
General Hospital ◽  
Conversion Rate ◽  
Psychiatric Hospitals ◽  
Patient Characteristics ◽  
Rare Occurrence ◽  
General Hospitals ◽  
Code Of Practice ◽  
Mental Health Act

Detention of general hospital in-patients under Section 5(2) is a rare occurrence. This study of the use of Section 5(2) in general hospitals uncovered a frequent neglect in following the guidelines of The Mental Health Act and The Code of Practice. Surprisingly the conversion rate of Section 5(2) to Section 2 or 3 was similar to that seen in a number of other studies conducted in the quite different setting of large psychiatric hospitals. A number of patient characteristics were identified that appeared to influence whether 5(2)s were converted to an admission Section. Each general hospital needs to develop guidelines to be followed when staff feel that a patient should be detained under Section 5(2) – an example of such a policy is included.

Use of Section 5(2) in clinical practice

1992 ◽  
Vol 16 (01) ◽  
pp. 14-16 ◽  
Author(s):  
Christina Pourgourides ◽  
V. P. Prasher ◽  
Femi Oyebode
Keyword(s):  
Mental Health ◽  
Clinical Practice ◽  
Psychiatric Hospitals ◽  
Annual Basis ◽  
Mental Health Act

The Mental Health Act (1983) came into being eight years ago but few studies into its use have been reported (West, 1987; Sackett, 1987). The Act provided for the setting up of the Mental Health Act Commission to safeguard the interests of detained patients and to monitor the use of the Act. The Commission visits ordinary psychiatric hospitals on an annual basis and writes a report of the visit. The Commission also submits a Biennial Report to Parliament. These reports address important issues but do not provide detailed information on the use of the various sections of the Act in differing hospitals.

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