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How Do We Make The Mental Health Act Better And Fairer?

28/11/2016 14:34

It's hard to think of an example of health jargon which carries as much potency as the term 'sectioned'. Said out loud and without the associations it brings about for your average person, actually nothing could sound more bland and inoffensive.

Yet being sectioned under the Mental Health Act is a reality - and sometimes unnecessarily painful reality - for thousands of people, their families and friends across the country each year. It means being detained under the Mental Health Act, a law which can allow someone to be admitted and treated in hospital against their wishes because they are too mentally unwell - or lack "capacity" - to make the right decisions about their healthcare.

While it can be the best thing to do for someone's health, as well as their own safety, being sectioned can be extremely distressing. For someone who is perhaps already hallucinating, experiencing delusions or feeling suicidal, imagine the fear it can induce to be taken somewhere unknown to you, by strangers.

For many of those people it is a particularly difficult moment in their mental health, but, and this is the critical point, it can, if done well, be something that puts in place the first building blocks for recovery.

Yes, ideally, no one would get to a point where they have to be sectioned. They would get support and treatment as soon as they start to become unwell, through their local mental health teams, and begin their recovery. But, as it stands, we remain a gulf away from "parity of esteem" where physical and mental health are on an equal par, and at present that means far too many people aren't in touch with mental health services until crisis point. So right now we have to make sure that the Mental Health Act works for the people it's there for. And right now, it's not.

A new report published last week by the Care Quality Commission (CQC) into the Mental Health Act showed that one in ten cases of sectioning have no evidence that the person's rights have been explained to them. Even if people are too unwell to take in information at the time they are detained, every effort should be made to explain things as soon as they are in a better state, which is what the Mental Capacity Act is all about, a piece of legislation which is specifically designed as a counter-weight, to protect the rights that still exist for those who are unable to make all or some decisions for themselves.

It's also really important that people are able to have a say in the sort of care and medication they get. In the CQC report we see that 29% of care plans showed no patient involvement. This is a rise of 4% since last year. Apart from this being a breach of a patient's rights, it also defies common sense. If someone is consulted on what works best for them, what has or hasn't worked in the past, and what sort of results they want to achieve in future, of course their treatment will be more successful. It's true in physical health and there is no reason why it can't be true in mental health.

While the report also highlights some examples of best practice where trusts are working hard to make sure the process is respectful and cooperative, ultimately the big picture is that things simply aren't good enough.

This is why we're working with the Mental Health Alliance, a consortium of over 70 organisations, to survey people with real life experience of the Mental Health Act - either as a patient, a carer or a professional - to understand what they think of the principles behind the Act. Some people think the Mental Health Act is excessive and not conducive to the protection of rights. Others don't feel the Act goes far enough to protect loved ones. There is therefore a complex balance to strike. What also often isn't clear is how much is down to practice, for example, squeezed resources, stigma, lack of training among police and other professionals, and how much is down to the failings in the Act itself. We hope that this survey will bring us greater clarity.

You can find the survey here
, and we want to hear from as many people as possible to get a comprehensive overview of what needs to change and why. So far we've heard from over 3000 people, but we want to know what you think.

The Mental Health Act and how it is applied is in need of review, and we want to work with the Government to make sure that people with severe mental illness are listened to. As detentions continue to rise we need more urgency in fixing persistent problems, and ultimately the Act needs to work for those people it's there to protect.

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