National Health Service

Surge in mental health treatment by force

There has been a sharp rise in the number of people with mental health problems being treated under compulsion.

The NHS information centre last month revealed a 14% increase over a two-year the use of detention powers under the Mental Health Act.

One campaigner said the threat of compulsory treatment now “hangs heavy” over patients.

In March 2007 there were 15,300 people compulsorily detained in NHS and private hospitals.

By March this year there were 700 more patients (16,100)detained.

Plus, in March there were 1,755 patients on a community treatment order (CTO). These were introduced in November 2008.

This totals 2,155 more patients in March being treated under compulsion than two years previously.

However, Anthony Deery, head of mental health operations at the Care Quality Commission, told journalists that he believes there is no evidence that CTOs, in particular, are being used inappropriately.

“CTOs are still very new,” he said. “We need to look at evidence across a greater period of time in order to draw conclusions about whether they are being used appropriately and effectively.

“To date, we don’t have evidence that CTOs are being used inappropriately.”

However, But Ruth Cartwright, professional officer at the British Association of Social Workers, suspects psychiatrists use CTOs to “free up” beds.

“That could mean some patients are set up, released before they are ready and when they are likely to fail,” she said.

Dr Rowena Daw, vice-chair of the Mental Health Alliance, representing more than 70 organisations monitoring the Mental Health Act, said “While positive risk taking and choice are being seen as the way forward in all other parts of health care, the extension of compulsory mental health care takes us backwards and compounds the stigma of mental illness.”

She added: “There is also evidence that a high proportion of CTOs are being issued to people from black and minority ethnic communities.

Paul Farmer, chief executive of the mental health charity Mind, said: “The focus on coercion detracts from individuals’ ability to rebuild their confidence and independence, both crucial for effective recovery, and the threat of compulsory treatment hangs heavy over their heads to the detriment of their mental health.

“We urge the Care Quality Commission to investigate these higher than expected numbers as a matter of urgency.”

Last year research in the British Medical Journal showed that enforcement of powers to detain people under mental health law increased by a fifth over ten years.

And earlier this year research in the Journal of Advanced Nursing stated that forcibly treating psychiatric patients with medication has no solid evidence to support its use.

“The dearth of literature on this topic means that coerced medication is not an evidenced-based practice,” said the British researchers.

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