Mental Health Act detentions hit record levels

Use of Community Treatment Orders increases by 10% and Section 136 detentions by police rise for fifth consecutive year

The number of people detained under the Mental Health Act by social workers and other professionals has hit its highest level, official figures show.
Data from the health and social care information centre reveals that 48,600 people in England were detained under the Mental Health Act in 2011-12, an increase of 5% from 2010-11. The number of detentions is now at its highest level since monitoring of the Mental Health Act 2007 was introduced in 2007-08. 

The number of people discharged from hospital under community treatment orders (CTOs) also rose to 4,200 in 2011-12, an increase of 10% on the previous year. CTOs place people on compulsory supervised community treatment with strict conditions.

The College of Social Work’s approved mental health professional (AMHP) network is currently investigating social workers’ experiences of CTOs amid concerns that some doctors may be using them “coercively”.

Section 136 orders rise for fifth year running

Detentions by police officers under section 136 of the Mental Health Act rose for the fifth consecutive year.

There were 14,902 people detained under section 136 orders to NHS units as a place of safety in 2011-12, an increase of 5.6 per cent from the previous year and more than twice the number detained in 2007-08. 

Another 8,567 people were detained under section 136 and placed in police custody. The 2011-12 report is the first time this data has been recorded – social workers and police officers have previously raised concerns that ‘place of safety’ detentions in police custody were going unmonitored. Official guidance states that police stations should be used as places of safety in “exceptional circumstances only”.

The use of section 136 orders has been a continuing area of debate among police officers and social workers. Both professions have previously raised question marks over the accuracy of section 136 data while AMHPs have raised concerns that police use the orders “inappropriately” in some areas.

Tim Straughan, chief executive of the health and social care information centre, said: “Many people working in the area of mental health will be interested to know the extent to which police custody is being used and the fact that more than one in three place of safety orders is to police custody rather than a hospital.”

Daisy Bogg, a mental health social worker and AMHP, said:

“There are a whole range of issues contributing to the rise in detentions. For example the economic situation, the shortage of jobs and rising debts can impact on mental health. People are more likely to be acutely unwell when they go in to inpatient units now. Plus there is pressures on mental health beds which mean there is pressure to get people out of them leading to increased relapse and readmission rates.”

“You’ve also got cuts to community services meaning there is less ability to manage people in community settings.”

Simon Lawton-Smith, Head of Policy at the Mental Health Foundation said the rise in detentions was “extremely worrying”.

“Recent cuts to mental health services will only make the situation worse. But we need commissioners to be bold in investing more in prevention and early intervention services, to reduce the number of people who become so unwell that they need expensive compulsory treatment in the future,” he added.

“The reported 11% increase in the number of people subject to a CTO is a particular concern. We know they are used disproportionately among some patient groups, such as Black African-Caribbean men. We need better evidence that they are being applied appropriately as a less restrictive alternative to hospital detention, and not just as a way of freeing up scarce beds.”

Related articles:

How the latest Mental Health Act research should inform social work practice
The mental health bed crisis forces us to place sick people in cells
AMHP leads investigate social worker experience of CTOs

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