CQC reports one in five mental health patients have not had their rights explained before being detained

The Care Quality Commission (CQC) has expressed concern over the number of people being detained under the Mental Health Act who are not being informed of their legal rights or being fully assessed for their ability to consent to treatment.

The CQC have also raised questions over whether people who are detained have easy access to impartial advice if they need it.

Today, the CQC published its fifth report on the use of the Mental Health Act which details that 16 per cent of records inspected did not indicate that patients have been provided with information on their rights and 18 per cent said that these had not been discussed either.

More than 23,000 people were affected by the Mental Health Act during March 2014 leaving more than 4,000 of those not being informed of their rights.

Deputy chief inspector of hospitals and lead for mental health at the CQC, Dr Paul Lelliott, said: “Under the Mental Health Act, healthcare workers have the power to deprive people of their liberty and to compel them to take treatment that they do not want. It is essential in a society that respects human rights that every possible safeguard is in place to protect and empower people who are affected by the MHA.

“It is unacceptable for any patient detained under the Mental Health Act or made subject to a community treatment order to be unsure of their legal rights or to not be told immediately how they can obtain independent advice and advocacy.”

More should be done to ensure people receive the correct information

Despite improvements in the number of records inspected detailing that they had been informed, the CQC insists that more should be done to ensure people with mental health problems receive the correct information.

Dr Lelliot continued: “Doctors and nurses do not treat people for a physical illness without explaining what is involved and asking for their consent. The same should apply to the treatment of people detained under the MHA. Staff should engage in a full discussion of the treatment plan and ascertain whether the patient is able and willing to consent.”

Further findings from the CQC indicated that patients being able to consent to treatment was a problem, of 3,342 records assessed during visits in 2013/2014, inspectors found that almost 25 per cent lacked evidence of patients being assessed as being willing and able to consent to treatment.

The CQC inspected some mental health facilities and discovered that some people in their care were not able to easily access impartial advice and almost 30 per cent did not offer patients information on local mental health services that could offer advice and support. The Care Quality Commission found that only 14 per cent of local authorities surveyed admitted to carrying out an assessment on the demand for independent advice services in their local area.

After further correspondence with carers and families, they found that many relatives and next of kin are unsure of the laws surrounding people being detained under the mental health act for days, weeks or months at a time. The CQC has implemented the findings of the 2013/2014 inspections to create a new Code of Practice which will represent the recognised standard care for people under the Mental Health Act.

'The findings within our report should be a strong wake-up call'

The Mental Health Act requires services such as hospitals to provide patients with information on why they’re being detained and give them the right to consent to or make a complaint about their treatment. In addition the Act recognises that people detained should have access to Independent Mental Health Advocacy to allow patients to understand and make informed decisions about their treatment.

Dr Lelliot added: “The findings within our report should be a strong wake-up call to those who commission and manage these services. We expect to see improvements.

“We have already used these findings to improve our inspection model for services that use the MHA and to strengthen the Code of Practice so that people affected by the Act can receive better care.”

Sophie Corlett, head of external relations at mental health charity Mind, said: “Whilst the CQC is reporting improvements in some areas of mental health services, especially with regards to patients’ ability to access to legal information, it is clear that there is still much to do. We are particularly concerned that overall uses of the Mental Health Act are still increasing year on year. It was used over 53,000 times in 2013/14, which is 30 per cent higher than 10 years ago.

“It is possible that the increasing use of the Mental Health Act points to the fact that people are simply not getting the support they need early enough and are therefore entering mental health services when they are considerably more unwell.

“Recent research also suggests that doctors are being forced to section people under the mental health act simply to secure a bed for otherwise voluntary patients. It is wholly inappropriate to use this power in such a way, but unsurprising that medical staff feel that they have no alternatives when services are so grossly overstretched.

“Excellent crisis care does exist, but today’s report is a stark reminder of just how much needs to be done to make sure that all people with mental health problems get the help they need.”

During 2014, the CQC began inspecting mental health services using new procedures, including ensuring that people are treated and assessed with dignity and respect. The commission continues to monitor information on processes, government systems and information on services designed to protect the rights of mental health patients.