A committee of MPs has found that more needs to be done to protect the interests of patients who rely on mental health services.
The House of Commons Health Committee has undertaken a review of the 2007 Mental Health Act and found that, in the words of its chair Stephen Dorrell MP, “many vital safeguards are not working effectively.”
Summarising the review, Mr Dorrell (pictured) said: “In 2007 the Government legislated changes to the Mental Health legislation and introduced new ‘Deprivation of Liberty Safeguards’ (DOLS) to protect patients who lack mental capacity – typically patients who suffer from dementia or severe learning difficulties.”
Those provisions are not working well, he said, and are often ignored.
“The current approach to these vital safeguards is profoundly depressing and complacent and the Government must immediately instigate a review which details an action plan for improvement.”
The committee’s inquiry also found that many mental health patients have difficulties in accessing hospital treatment, to the extent that some staff were resorting to sectioning to obtain a bed.
Said Mr Dorrell: “Many psychiatric wards are over capacity and there is huge pressure on beds; nevertheless, we were shocked to learn that there is evidence that patients who need hospital treatment are being sectioned unnecessarily in order to access a bed. This represents a serious violation of patients’ basic rights and it is never acceptable for patients to be subjected to compulsory detention unless it is clinically necessary.
“A clinician who is complicit in this approach has compromised their professional obligations; both the professional regulators and the Government should urgently investigate the prevalence of this practice within the mental health system.”
A further cause for concern was the effectiveness of Community Treatment Orders (CTOs), which were also introduced by the 2007 Act and enable patients to be treated in the community, while still being subject to recall to hospital if their condition deteriorates.
Mr Dorrell said of these: “The principle of supervised community treatment is welcome, but they have not worked as the legislation intended. A convincing body of evidence was presented to us questioning whether CTOs prevent readmission to hospital; there is wide variation in the use of CTOs across the country and the availability of this new form of community treatment has not reduced the number of patients detained in hospital.”
The committee was concerned at the possibility that pressure on hospital beds may be driving an increased use of CTOs.
“Financial pressures should never distort clinical judgements, but the absence of clear guidelines for clinicians makes this all the more likely,” said Mr Dorrell. He called on the Royal College of Psychiatrists to take the lead in developing a “consistent approach to CTOs”.
Another area the MPs examined was the system of Independent Mental Health Advocates, whose function is to help patients take advantage of their rights while they are in hospital. The committee found that those who need advocacy the most are least likely to be able to access an appropriate service, according to Mr Dorrell.
“Worryingly, we were told that the presence of independent advocates has resulted in some clinical staff retreating from their obligations to help patients understand their rights. The committee is in no doubt that a patient’s primary advocate should be their clinician and independent advocates, ultimately, provide an important, but supplementary, service.”