Mental health services must do more to protect people with learning disabilities, leading learning disability charities have said.
Mencap and the Challenging Behaviour Foundation made this call after care regulator the Care Quality Commission published its Mental Health Act Annual report, in which MHA commissioners voiced concern about cultures of control and containment that are enforced over all detained patients. These kinds of rules can become institutionalised and carry the risk of stripping patients of their autonomy and dignity.
More widely, the report found that 15% of people receiving care under the Mental Health Act are not being involved in the decisions made about their care. Additionally, 37% of care plans it checked showed no evidence of involvement of the person who had been sectioned.
The report also found that the number of people subject to the Mental Health Act (MHA) is rising. In 2011/12, there were 48,631 detentions, a rise of 5%, and another 4,220 Community Treatment Orders were issued, a rise of 10%.
Meanwhile, almost half (45%) of patient records reviewed still showed no evidence of consent to treatment discussions before being given medication.
However, the report also noted that some hospitals and wards are doing a very good job in treating patients with dignity and respect and, for the first time, it highlights specific examples of good practice.
David Behan, chief executive of the CQC, said: “People who need treatment in hospital for their mental health should have care and support to help them recover.
“Some hospitals are doing a very good job in treating people with dignity and respect – so we know it’s possible. However, CQC is concerned that some hospitals have allowed cultures to develop where control and containment are prioritised over treatment and care.
“We will be making mental health a high priority this year and the information gained through our Mental Health Act visits and from other strategic partners will direct our inspection work. Where we witness poor and unacceptable care we will use all the powers that we have to ensure that these practices change.”
However, learning disability charities have voiced their concern about some of the findings of the report. In a joint statement, Mencap and The Challenging Behaviour Foundation said: “The CQC report highlights that mental health services are failing to protect vulnerable people. Mencap and The Challenging Behaviour Foundation are deeply concerned that in many hospitals, abusive practices, such as patients being over-restrained, locked up and over medicated, are being allowed to continue. People's needs are simply not being understood.
“People with a learning disability are particularly vulnerable, because they often can't speak up for themselves. At Winterbourne View, where shocking abuse was uncovered in 2011, most of the people with a learning disability had been sectioned under the Mental Health Act. The abuse, bullying and humiliation which took place there included the inappropriate use of restraint.
“The CQC recognises that urgent action is needed. This must address the needs of people with a learning disability."