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Changes in the use of the Mental Health Act 1983 in England 1984/85 to 2015/16

Lookup NU author(s): Dr Patrick Keown, Dr Iain McKinnon

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This is the authors' accepted manuscript of an article that has been published in its final definitive form by Cambridge University Press, 2018.

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Abstract

Background Concerns have been raised about the increase in the use of involuntary detentions under the Mental Health Act in England over a number of years, and whether this merits consideration of legislative change. Aims To investigate changes in the rate of detentions under Part II (civil) and Part III (forensic) sections of the Mental Health Act in England between 1984 and 2016.Method Retrospective analysis of data on involuntary detentions from the National Archives and NHS Digital. Rates per 100,000 population were calculated with percentage changes. The odds of being formally admitted to an NHS hospital compared to a private hospital were calculated for each year.Results Rates of detention have at least trebled since the 1980s and doubled since the 1990s. This has been due to a rise in Part II (civil) sections. Whilst the overall rate of detentions under Part III (forensic) sections did not rise, transfers from prison increased whilst detentions by the courts reduced. The odds of being detained in a private hospital increased fivefold.Conclusions The move to community based mental health services in England has paradoxically lead to an increased number of people being detained in hospital each year, and in particular an inexorable rise in involuntary admissions. This is likely to be partly due to improved case finding with an increased focus on treatment and risk management, and partly due to changes in legislation. An increasing proportion of this government funded care is being provided by private hospitals.


Publication metadata

Author(s): Keown P, Murphy H, McKenna D, McKinnon I

Publication type: Article

Publication status: Published

Journal: British Journal of Psychiatry

Year: 2018

Volume: 213

Issue: 4

Pages: 595-599

Print publication date: 01/10/2018

Online publication date: 02/08/2018

Acceptance date: 28/05/2018

Date deposited: 28/05/2018

ISSN (print): 0007-1250

ISSN (electronic): 1472-1465

Publisher: Cambridge University Press

URL: https://doi.org/10.1192/bjp.2018.123

DOI: 10.1192/bjp.2018.123


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