Changing patterns in the use of the Mental Health Act 1983 in England, 1984-1996 (original) (raw)
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Forensic psychiatry assessments and admissions from East London, 1987 – 94
Journal of Forensic Psychiatry & Psychology, 2004
There is a shortage of information on the relationships between resources available to Regional Medium Secure services, demand from catchment area populations, and clinical factors which determine whether patients assessed are actually admitted. During a 7 year study period, the East London Service had few resources and the assessment process was entirely reactive in that all referrals were generated by external agencies. Patients selected for admission were primarily serious offenders with schizophrenia specifically referred for admission to medium security. The inpatient service was heavily reliant on admissions to the private sector. Needs of the catchment area population could not be met and it was necessary to prioritise a limited subgroup of mentally disordered prisoners at the expense of supporting local services and patients inappropriately remaining in maximum security. These findings are of contemporary relevance to the continuing lack of capacity in other medium secure services in the UK. Future service planning based on the 'rates-under-treatment' approach in the absence of adequate epidemiological data is discredited by these findings.
Admissions to a national forensic hospital 1997-2003
Irish Journal of Psychological Medicine, 2008
Objectives: We set out to review all admissions from the criminal justice system to the Central Mental Hospital from January 1997 to December 2003, with particular attention to patient diagnoses, offences, source of admission, length of stay, and patterns of discharge. This study was undertaken to assist with future service planning and determination of resource needs.Methods: The service maintains a combination of electronic and handwritten records of all admissions. Information was extracted concerning all admissions from January 1, 1997 to December 30, 2003. The data was analysed using a statistical package, SPSS 11.0 for Windows.Results: Nine hundred and eighty-six admissions of 780 individuals from the criminal justice system were recorded from January 1997 to December 2003. There has been an increase in the proportion of patients admitted suffering with severe mental illness. There has also been a significant shift in the pattern of discharges, with a higher proportion of pati...
Patterns of use of the Mental Health Act 1983
BJPsych Open, 2019
Trends in detention under the Mental Health Act 1983 in two major London secondary mental healthcare providers were explored using patient-level data in a historical cohort study between 2007–2008 and 2016–2017. An increase in the number of detention episodes initiated per fiscal year was observed at both sites. The rise was accompanied by an increase in the number of active patients; the proportion of active patients detained per year remained relatively stable. Findings suggest that the rise in the number of detentions reflects the rise of the number of people receiving secondary mental healthcare.
Medicine, Science and 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.
Dangerous or merely ‘difficult’? The new population of forensic mental hospitals
European Psychiatry, 2009
BackgroundDuring recent decades, there has been a substantial increase in admissions to forensic mental hospitals in several European countries. It is not known if reforms implemented in mental health policies and practices are responsible for this development.ObjectiveOur study examined the development of mental health care in Austria and the incidence and prevalence of mentally disordered offenders judged not guilty by reason of insanity (NGRI).MethodsWe analysed data on service provision and data from criminal statistics between 1970 and 2008 from several national sources.ResultsDuring the first decade when reforms to mental health practice were implemented, the incidence and prevalence of offenders judged NGRI remained unchanged, despite a reduction of mental hospital beds by nearly 50% and little outpatient care. Surprisingly, the enormous increase in admissions to forensic inpatient treatment began in Austria only after community mental health services were rolled out across t...
The Mental Health Act Commission, Ninth Biennial Report, 1999–2001
International Journal of Mental Health and Capacity Law
The Commission was established in 1983, as a Special Health Authority, following publication of the Boynton Report. 1 The report recommended the creation of such a Commission, the functions of which 'might include ... the independent investigation of more serious complaints (from whatever source).' The Commission's statutory functions are much more limited than those exercisable by the Commissions in Scotland and Northern Ireland. Its main functions are to keep under review the way in which the powers and duties set out in the Mental Health Act 1983 are exercised in relation to people who are liable to detention; to arrange for persons to visit and interview detained patients; to investigate complaints within its jurisdiction; to perform the Secretary of State's consent to treatment functions under Part IV of the Act; and to review any high security hospital decisions to withhold post. Positives The biennial report is well presented and well written, and much of the credit here must go to Mat Kinton, one of the Commission's stars. It is a compassionate document, and gives an excellent summary of where mental health services stand. These features reflect the kindness, commitment and skill of its members, and of those who helped them to prepare the report. There is an excellent passage on the effects of the safety and security directions on patient care in the high security hospitals, and useful information about the Commission's survey of all ECT facilities in England and Wales. The output data published in the report provides incontrovertible evidence of the tremendous workload of underpaid but dedicated Commissioners.