Mental Health Act – The rise in the use of the MHA to detain people in England

This report looks at causes for the rise in use of the Mental Health Act (MHA) to detain people.

National data shows an increasing use of the Mental Health Act (MHA) to treat people in hospitals.

In 2016, we committed to working with local services to gather views on the reasons for the national increase in the use of the MHA, to identify how local services are responding to the changing activity, and to help inform the targeted work planned to bring about improvement.

This report presents our findings.

What we did

The main purpose of the review was to bring the perspective of patients, carers and staff in local services to the national debate about the causes of the rise in rates of detention.

The report is based on information from three sources:

• A review of data
• Site visits to 8 NHS trusts, 2 independent mental health service providers and 23 local authorities
• Engagement with service users, advisors and other stakeholders

What we found

• Patients, carers and staff agreed that an increased focus on early intervention and intensive support in the community had the greatest potential to reduce admissions to hospital and likelihood of using the MHA
• Some of the rise in detention rates might be the result of population changes and in social factors that influence the use of the MHA
• Changes to mental health law and to policy guidance over the past decade may have contributed to the rise in rate of detentions as an unintended consequence
• It is possible that some of the increase in the use of the MHA is due to features of the way that data about the use of the MHA are managed

Our conclusions

• There is no single cause for the rise in rates of detention this decade. It is highly likely that a range of factors are at play both nationally and locally
• The rise in part suggests a system under considerable pressure
• We found no evidence that professionals are using the MHA to admit people who do not meet the criteria for detention
• Action must be taken to address underlying problems – reform of mental health legislation on its own is unlikely to reduce the rate of detention