There were thousands more detentions under the Mental Health Act in 2021/22 than in 2016/17, according to an investigation by The Doctor – a magazine by the British Medical Association.
The analysis of NHS data found there has been a 16% rise in the number of detentions under the MHA over the last five years, from 45,864 in 2016/17 to 53,337 in 2021/22.
This number has been steadily rising year on year, and The Doctorset out to discover why this may be. To do this, they interviewed leading psychiatrists and other healthcare professionals, academics, charities and policy experts.
These professionals painted a picture of overloaded and services, low bed stock and burnt out staff.
Occupancy rates beyond what is considered to be safe
Indeed, while the number of NHS mental health beds has dropped by roughly a quarter over the last decade (from 23,607 in 2010/22 to just 18,029 in 2022/23), mental health referrals have soared, from 3 million in 2016 to 4.6 million in 2022.
This has resulted in occupancy rates of around 87–90%, where 85% is the ‘risk threshold’, the level generally considered to be the point beyond which safety and efficiency are at risk.
These high occupancy rates are putting added pressure on clinicians and mean that patients are not always getting the care and support they need.
Professor Tom Burns told The Doctor that 20 years ago, a typical ward that could hold up to 20 patients would normally have about five patients at any one time. Now, these wards are close to capacity, with around 18 patients on section.
Not only is this stressful for staff, but it also puts patients at risk, says Sir Robin Murrary, professor of psychiatric research at the Institute of Psychiatry at King’s College London.
This is because many of the patients on these wards are “acutely psychotic”, he says, resulting in an unpleasant environment in which patients can “interact and make each other worse.”
This is resulting in more and more staff leaving the profession, and vacancy rates of medical professionals working in mental health services more stand at 15%, up from 11% in 2017.
Link between mental health, poverty and drug use
The investigation by The Doctor also highlights the link between drug use, poverty and mental health issues.
Dr David Rhinds, a Nottingham-based consultant addiction psychiatrist, says that drugs are ‘precipitating factors for mental illness’, and now, with a lack of community drug teams and specialists within the NHS, we are seeing a rise in drug induced mental illnesses.
Rob Poole, professor of social psychiatry at Bangor University, says there is also a definitive link between income inequality, adversity and major mental illness, particularly inner-city poverty.
In fact, the detention rate in affluent areas is 42.1 per 100,000, while the detention rate in deprived areas is 153.3 per 100,000.
More funding needed to ensure patients are kept safe
In light of these findings, the BMA is now calling for a sharp increase in funding for mental health services and staff which will enable to services to keep on top of the demand they are facing.
In addition, the doctor’s union says there must be increased investment in primary care, public mental health, mental health research, and the mental health estate, acknowledging the importance of all the roles in mental health treatment.
Without this investment, patient care will continue to suffer, with fewer and fewer getting the care they deserve.