Dementia and less community support causing rise in mental health detentions

England has seen a rise in the number of people being detained under the Mental Health Act and this is due to an increase in the number of people with dementia, less support in the community and a change to the definition of a mental disorder.

In the ten year period between 2005/06 and 2015/16, the number of detentions has risen by 40 per cent – from 45,484 to 63,622.

A review by the Care Quality Commission found no evidence that professionals had been misusing the Mental Health Act in any way.

Dr Paul Lelliott, deputy chief inspector of hospitals (lead for mental health) at the Care Quality Commission, said: "There is no single reason to explain why detentions continue to rise every year. Population growth, societal changes, better national reporting, duplicate reporting, increased awareness of mental disorder and expanded criteria for detention are all contributing to more and more instances of people being sectioned under the Mental Health Act.”

He added that "some of the factors at play in the rising rates of detention, both nationally and locally, are also signs of a healthcare system under considerable strain.

“Detentions under the Act can be influenced by gaps in support and provision in the system. This includes limited hospital bed availability, which means that people cannot easily be admitted as voluntary patients early in the course of their illness. This is a particular problem if it is coupled with limited support for people in the community, which can prevent a person’s mental disorder from deteriorating to a point that detention under the Act is necessary.”

He called for changes to the law alongside action to address the wider problems.

Healthcare professionals can apply to detain people under the Mental Health Act to ensure they receive the treatment, care and support they need in hospitals. Although it is in the person’s best interests, it is against their wishes.

For this reason, the law is supposed to be used only when other options have been considered already, such as whether support can be provided in the community or if the patient can be cared for in hospital on a voluntary basis.

CQC looked at the reasons behind the rise in the number of detentions by reviewing available data, visiting specialist mental health (independent and NHS) services, and by speaking to patients and to representative bodies to gather their views.