stressThe Deprivation of Liberty Safeguards (DoLS), which are meant to protect people who lack capacity, are not working well and need to be reviewed, a Parliamentary committee has concluded.

The Parliamentary Health Select Committee’s review of the working of the 2007 Mental Health Act found that DoLS – introduced to protect patients who lack mental capacity, typically patients who suffer from dementia or severe learning difficulties – are not working well.

“We found that it is commonplace for DoLS to be ignored leaving many people at heightened risk of abuse,” said Committee chair Stephen Dorrell MP. “DoLS are seen as complicated and difficult to implement, but this is no excuse for the extreme variation in their application across the country. 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.”

Independent advocacy

The MPs also looked into the use of Independent Mental Health Advocates, which aim to help patients take advantage of their rights while in hospital. However, they found that those who need advocacy the most are least likely to be able to access an appropriate service.

“Local authorities are responsible for commissioning a suitable service and Health and Wellbeing Boards should seek firm evidence from them that a high quality advocacy is available for all patients,” Dorrell said.

“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.”

The Mental Health Alliance welcomed the Health Select Committee's report. Alliance chair Alison Cobb said: "We welcome the Committee's recognition of the need to improve the use of DoLS. The links between mental health and mental capacity legislation are still poorly understood in many places. Improved understanding of how to use the Mental Capacity Act is vital to ensure people's human rights are being upheld at all times.

"We also welcome the Committee's call for improvements in the availability of independent advocacy. We agree with the Committee that the way the Mental Health Act is administered is fundamental to achieving 'parity of esteem' between physical and mental health. Without investment in the best possible mental health care at a time of crisis, parity will remain a distant aspiration."