Healthcare Inspectorate Wales report: “Patients coerced into accepting treatment.”

Healthcare Inspectorate Wales’ (HIW) second annual report monitoring the use of the Mental Health Act in Wales during 2010 – 11 has found that “patients are not always being made aware of their rights” and that some have been “coerced into accepting treatment”.

HIW is required to prepare an annual report that gives an account of the work they have undertaken to meet their Mental Health Act monitoring responsibilities. Commenting on the latest report HIW Chief Executive Dr Peter Higson said: “Generally we found that the correct legal processes had been followed when patients were detained under the Mental Health Act. However, our report identifies areas where improvements need to be made in the overall provision of care and treatment.”

In 2010-11 HIW spoke to 140 detained patients and examined the records of approximately 200. Some patients consulted by the inspectors reported that “they felt coerced into accepting treatment or staying in hospital informally through being told that they would otherwise be detained.” Further concerns related to patients’ rights, gaps in provision, record keeping and “variable” access to psychologists.

The report stated: “We are particularly concerned that record keeping in relation to consent to treatment was not always appropriately followed. As the Act allows for some medical treatment for mental disorder to be given without an individual’s consent it is important the correct procedures are followed by organisations. We are also concerned that patients were not always being made aware of their rights in a timely manner.

“The lack of activities and therapeutic input that was evident in many settings needs to be addressed and we will continue to focus on this matter in the year ahead. Access to therapies including psychologists was found to be variable between organisations. This is concerning as such therapeutic input can assist in recovery and lead to shorter periods of detention.”

Commenting on the report’s findings Hafal Chief Executive Bill Walden-Jones said: “As a patient-led charity for people with serious mental illness – those who are most likely to be subject to the Act – we are very concerned about the findings of the report.

“One of our key aims as an organisation is to ensure that patients gain the rights they deserve – and that they are empowered to exercise them, so it’s concerning that the report found that patients were not always being made aware of their rights, and that the correct procedures are not always being used in relation to patients’ consent to treatment.

“What especially concerns us is the lack of therapeutic input in many hospital settings, including the lack of access to talking therapies. It is essential that when a person is detained under the Act they are given the most effective support to become well again and get on with their lives.”

Responding to the report a Welsh Government Spokesperson told the BBC: “We welcome the HIW report and will now consider the detail, as well as any further work that is needed to ensure the (Mental Health) Act is being applied appropriately.

“Under the new Mental Health (Wales) Measure 2010, more service users will have access to independent mental health act advocates and increased involvement in care and treatment planning.”

To download a copy of the report please visit: