Mental health clients distressed by appeal delays

There are too many delays when patients appeal to a tribunal against their detention under the Mental Health Act, according to a ground-breaking report.

The report – Patients’ Experiences of the First-Tier Tribunal (Mental Health) – found that delays are a substantial factor in many patients’ negative experiences of the tribunal, with nearly half reporting they had been subject to a hold-up of some description with some experiencing significant distress and anxiety.

A significant cause for concern was a lack of information, with nearly half receiving little or no information about how long the tribunal process was likely to take.

Of those who believed they had been subject to delays, a third had not received or understood any reasons for the delay. However, the report said the Tribunals Service was trying to reduce delays.

This was one of a series of findings into the experience of appearing before the First Tier Tribunal (Mental Health), formerly the Mental Health Review Tribunal, and represents the first time the information has been gathered to this extent.

It was commissioned by the Administrative Justice and Tribunals Council (AJTC) and the Care Quality Commission (CQC), whose Mental Health Act commissioners carried out more than 150 interviews with patients who volunteered to participate in the study.

In 2009-10 the First-tier Tribunal (Mental Health), which serves England, dealt with just over 25,000 appeals, almost 5,000 more than the previous year.

The introduction of community treatment orders in November 2008 accounted for a significant part of this increase.

Among other key points:

• Patients’ experiences of tribunals were diverse, ranging from positive to strongly negative.

• Patients are not always well placed to ensure their lawyers are providing a good standard of advice and representation.

• The way pre-hearing medical examinations are carried out is very variable.

• A significant minority said they were not given enough time to be heard by the tribunal.

• Nearly all said they received a very rapid decision. However, follow-up information was lacking and patients felt poorly informed of any further right to appeal.

The report made a series of recommendations, including further points about cutting down on delays.

Chairperson of the AJTC Richard Thomas said: “We trust that the findings of this study will enable further improvements to be made.”

CQC chair Dame Jo Williams said it was important for patients’ well-being that they come out of the tribunal hearing feeling that they have been treated fairly and given every opportunity to make their case.

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