Mounting pressure to deliver improvements in mental health care

Failures among NHS staff to properly apply standards laid down by the Metal Health Act are 'disempowering patients' and impeding their recovery, a health watchdog has found.

The CQC has warned of unacceptable variation in application of the Act

According to a new report by the Care Quality Commission (CQC), some mental health patients are not being informed of their full rights, while other are not being given a say in their care.

Trusts are also coming under increasing practical and financial pressures, as the number of people detained under the Act continues to rise and resources remain “tight”.

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And staff and managers at some trusts are not receving the support they need to get to grips with a new code of practice imposed by the Act.

The warning from the independent body comes as more than a dozen MPs – including nine former health ministers – appeal to the Prime Minister to step up efforts to improve mental health treatment.

The group, which includes Labour MP Alan Johnson and Tory MP Kenneth Clarke, argue that despite the Government’s “promises of change” too many people are still struggling to access services.

Writing in the Times they point out that suicide remains the biggest killer of men under 45 and people in crisis “are still routinely shunted across the country in search of a hospital bed”.

“We urge their successors to make good the promise of genuine equality,” they write.

The new report from the CQC – entitled Monitoring the Mental Health Act – provides an annual overview of patient care and protection of rights under mental health legislation.

It found that the number of people detained under the 1983 Act has risen for the sixth year in a row, with 2014/15 seeing the highest ever year-on-year increase of 10 per cent.

It notes that this comes at a time of “significant financial pressure” for the sector, when resources are “tight” and the number of inpatient beds is falling.

And it raises concerns about scale of variation in practice between trusts, including the quality of care, respect for patient rights and understanding of codes of practice.

The report states that “one in 10 records do not show evidence that patients have had their rights explained to them at the point of detention”.

“This leads to patients not knowing what to expect, or understanding their rights under the MHA,” it says.

“These are not technical issues of legal process, but failings that may disempower patients... and ultimately impede recovery.”

Commenting on the report, Lib Dem leader Tim Farron said it highlights the need for “urgent improvement”.

But he said it is difficult to see how this will be achieved when community mental health providers “are under such intolerable financial strain”.

Responding to the report, a Department of Health spokesperson said: “This report recognises that many hospitals are doing a very good job... but also that others need to learn from this good practice.

“Backed by additional investment and the transparency of studies like this, we’ll ensure even higher standards in future.”