Psychiatric inpatient services failing patients

In Place of Fear?, the eleventh biennial report of the Mental Health Act Commission (MHAC) that will be laid before Parliament today, has heavily criticised psychiatric inpatient services in England and Wales as having unacceptable levels of care and security and fostering a climate of fear.

Chris Heginbotham, Commission Chief Executive, explained: “The Report highlights a number of Commission concerns about mental health care. Mental Health Act Commissioners find serious abuses of the rights of patients every week – which in 2006 is simply inexcusable. We are especially worried about complacent and often lax use of the Mental Health Act; some provider attitudes demonstrate a lack of understanding of the significance of depriving a person of their liberty.”

Specifically the Report highlights the following issues:

• Inpatient mental health services are under severe pressure, with some services unable to provide their patients with acceptable levels of security, care, or a sense of being treated as someone who matters.

• Inpatient services are losing staff and resources to community services, but pressures on inpatient beds remain high.

• There are risks to specialist service provision posed by the devolution of service commissioning to Primary Care Trusts in England, and the vulnerability of mental health services generally as NHS Trusts face severe financial crises.

The Report also brings attention to declining rates of diversion of mentally disordered from custody at the point of sentence and declining proportions of prison transfers to hospital. The report calls for reform of the concepts of criminal responsibility, a review of the role of the Home Office in taking decisions about the care of mentally disordered offenders and a refocus on diversion of mentally disordered people from the criminal justice system, arguing that “a just society does not punish its members for being mentally disordered”.

Responding to In Place of Fear?, the eleventh biennial report of the Mental Health Act Commission, Bill Walden-Jones, Chief Executive of Welsh mental health charity Hafal, stated:

“There are no surprises in this Report – many of our clients are more than aware of the climate of fear in inpatient psychiatric wards that the Report describes. The distressing fact is that patients in a vulnerable state are exposed to an environment that is far from therapeutic, often with a lack of beds and staff, and unacceptable levels of care and security. The reality is that mental health services are under severe pressure and, as a result, people with severe mental illness are not getting the care or the respect they deserve.

“We also welcome the Report’s insights into the treatment of mentally disordered offenders. Our own research has found that a disproportionately high percentage of people within the Criminal Justice System have a mental illness – often a severe mental illness – and that they are not getting timely or appropriate treatment for this. The Report’s exposure of the failure of court diversion processes also confirms an unacceptable number of people continue to enter the Criminal Justice System when they simply should not be there.

“The Assembly Government has stated that mental health is one of its health priorities, and has recently committed itself to a revised National Service Framework for adult mental health services. In light of this damning Report, it is essential that the Assembly addresses the issues immediately, lives up to its promises, and makes patients’ rights its priority.”

To read the Mental Health Act Commission Report, go to: