NSUN unable to endorse the final Mental Health Act survey report

NSUN strongly emphasised the need for further research to be undertaken before the completion of this study and circulation of the report, to ensure that those most affected by the Act were adequately represented in the report.

The National Survivor User Network (NSUN) is an independent, user led network of people and groups with lived experience of mental distress, disadvantage and mental health service use. Many of our members have been subject to the Mental Health Act and have called for the Mental Health Act to be reformed. A call for it to be made fully compliant with Human Rights legislation and ensure that people are not harmed or abused is included in our NSUN Members’ Manifesto 2017.  

As a member of the Mental Health Alliance, NSUN welcomed the possibility of research that was designed to gather views on the principles of the Mental Health Act from those who use mental health services, are a family member, or carer or a mental health professional. This is particularly important following Theresa May’s announcement of her intention to reform the Mental Health Act. 

The Alliance Mental Health Act report helpfully highlights that 49% percent of respondents did not think that people are treated with dignity under the Mental Health Act and 50% did not consider that their human rights would be protected if they were detained. NSUN members also have very strong concerns about the Act in these respects and have clearly told us that the rights of people should be respected and upheld and that the Act is out of date.

Whilst NSUN supported the need for a Mental Health Act survey we are unable to endorse the Mental Health Alliance report for a range of reasons. The main areas of concern include:

  • Only 8% of the 61% of respondents who supplied demographic details came from black and minority ethnic (BME) communities. In addition, it is not clear how many of the 8% have personal experience of being detained under the Mental Health Act. Given that people from BME communities are particularly likely to be detained and subjected to compulsory treatment, we see these shortfalls as fundamental flaws in the report. The CQC 2016 Mental Health Act report continues to show black and black British people as having the highest rate of detentions. (Out of the 63000 people detained under the Mental Health Act in 2014-15, black people were disproportionately affected – with a detention rate of 56.9 per 100 patients compared with a rate of 37.5 per 100 among other patients).
  • Only 30% of those who supplied demographic information were male. However, men are just as subject to detention under the Mental Health Act as women and so their views need to be equally represented.
  • The overall percentage of respondents with previous experience of detention was only 14% and only 0.5% had current experience. Given the major impact on people's lives that the use of detention has, we would like to see 50% representation of people with experience of detention amongst survey respondents.
  • There is no information in the report about the views of respondents from different age groups. Because young people and older people may have particular concerns about mental health services, we consider that this is again a significant shortfall.

In our view, conclusions drawn in the report about the numbers of survey respondents who agreed with detention under the Mental Health Act are also over-stated and this supports the view of the Act as a legal sanction to restrict people’s rights rather than a measure to support people in crisis.

We believe that the survey does not adequately represent the people who are most affected by the Act. As such the survey has missed an important opportunity truly to show the views of people who are subject to the Act and the effects that it is having on those who are subject to its powers!

In a Guardian article, Mark Brown recently spoke about the Government’s pledge to replace in its entirety the ‘flawed Mental Health Act’, saying:

‘If we really wanted change we could aim much higher: imagine a bill of rights for those experiencing mental distress. A future bill could enshrine in law an entitlement to adequate social security benefits for those too unwell to work. No one should experience poverty as a result of mental ill health. Few people have access to someone to fight their corner while in hospital or treatment since true independent advocacy has withered due to cuts. That could change.’

In line with this, NSUN calls for a replacement of the Mental Health Act with a Mental Health Rights Act, so that people using mental health services are treated as equal citizens with access to the same rights as any other members of the public.

References

Mental Health Alliance report of the Mental Health Act survey 'A Mental health Act fit for tomorrow - An agenda for reform' published 23 June 2017.

NSUN (2017) NSUN Manifesto, our voice, our vision, our values http://www.nsun.org.uk/news/members-manifesto-2017/

Kalathil J (2008/2011): Dancing to our own tunes: Reassessing Black and Minotity Ethnic Mental health Service User Involvement. Review and reprint, NSUN http://www.nsun.org.uk/assets/downloadableFiles/dtoots-report---for-website2.pdf

Care Quality Commission (2016): Monitoring the Mental Health Act in 2015/16 http://www.cqc.org.uk/sites/default/files/20161122_mhareport1516_web.pdf

Brown M (May 2017): Theresa May wants to scrap the Mental Health Act. Here’s what should replace it https://www.theguardian.com/commentisfree/2017/may/09/theresa-may-mental-health-act-care