UK – Mental health services must involve patients in their care decisions, says CQC annual report

Compulsory Treatment Orders increase 10% in the last year

 The Care Quality Commission’s Mental Health Act Annual Report reveals that 15 per cent of people receiving care under the Act are not being involved in the decisions made about their care.  The CQC says that mental health services must do more to ensure that the care they provide to patients in hospitals is based on individual needs.

Under the Act a person with a mental disorder may be detained and treated in hospital against their wishes or treated in their community under a community treatment order (CTO).

Visits to people who are detained or on CTOs are carried out by Mental Health Act (MHA) commissioners. They check that patients’ basic human rights are being supported during their care and treatment under the Act.

During one visit, the commissioner discovered that none of the patients interviewed knew what was in their care plan. None of the patients felt involved in planning their care or in any decisions about their treatment.

In addition, some patients did not have any information about being discharged from hospital, including what they had to do to prove they could be discharged. Two of the patients that our commissioners spoke to did not even know they were detained or what they had done to warrant being subject to the Act.

Commissioners have, however, seen examples of hospitals that provide good care and treatment to patients who are detained under the Act.

The number of people subject to the Act is rising. Throughout 2011/12, there were 48,631 detentions (up five per cent) and another 4,220 CTOs were issued (up 10 percent).

Services are also under increasing pressure, especially in regards to the provision of Approved Mental Health Professionals who contribute to decisions about the detention of patients under the Act. Other areas showing evidence of pressure on services are transport to hospital wards, the increased demand for beds, increased workloads and access to psychological therapies.

The report also refers to a lack of understanding of the Mental Capacity Act 2005 by staff.

The full report can be downloaded here.

Dr Andrew McCulloch, Chief Executive of the Mental Health Foundation, commented:

“We are very disappointed that some organisations still fail to involve patients in care planning. Plans must take account of individuals’ needs and aspirations in order to be effective.

“It’s frustrating to see that the findings provided by the report remain pretty much the same year after year in showing large over-representation of certain black and minority ethnic groups. A lot of work has been done to identify the specific problems that need to be addressed, but neither Government nor providers seem willing to make the long term commitment to working with local communities that will be required to deliver change.

“Finally, we are very concerned by the reported lack of understanding of the Mental Capacity Act amongst many staff.”



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