Policy Manager Will Johnstone analyses the latest figures around detentions under the Mental Health Act for 2019-2020. The statistics are correct from April 2019 - March 2020, so the impact of the Covid-19 pandemic is minimal.

Nearly two years ago the Independent Review of the Mental Health Act published its vision for the future reform of our mental health legislation. As we approach the second anniversary of the publication of the Review on the 6th of December, the release of the annual Mental Health Act statistics shows why change is more important than ever.

While the dates that the statistics cover touches on the start of the Covid-19 pandemic in the UK, they are mostly unrelated to the changes caused by the first wave. This is because they cover the period between April 2019 and March 2020, and only the second half of March 2020 saw serious disruption to mental health services in the form of the national lockdown. Next year’s figures could look very different given the impact of the pandemic, but in the meantime, these figures tell us a lot about how little has changed since the Review was published in late 2018.

Crucially, the number of new detentions is above 50,000 for the first time since the recording system was changed in 2016. The true number is likely to be higher still, as not all providers are returning adequate data. Nevertheless, this threshold is an important one because it shows that detentions under the Act continue to rise, with even more people subject to the inadequate protection of the Act.

The disproportionate detention of the ‘Black or Black British’ ethnic group, at over four times the rate of the ‘White’ group, remains a cause for serious concern. This was one of the driving factors behind the Government’s decision to commission the Review.

While work is being undertaken by various organisations to address this, including NHS England’s work on a Patient and Carer Race Equality Framework to embed racial equality measurement and action within detention settings and ongoing research to examine models for culturally sensitive advocacy provision, far more work is needed to reduce the ethnic disparity in detention rates.

The statistics also show that the rate of detention is significantly higher in more-deprived areas. The most deprived areas of the country have a detention rate which is over three times higher than that of the least deprived. These worrying figures confirm concerns that economic inequality is linked to Mental Health Act detentions. We know there is a higher prevalence of serious mental illness in more deprived areas, although there may also be other factors at play in the higher rates of detention.

We are concerned that the impact of the pandemic, which has the potential to increase the prevalence of severe mental illness due to both a rise in economic hardship and the mental health impact of lockdown and collective trauma, may result in a further rise in detentions under the Act. The initial figures for monthly Mental Health Act detentions appear to be high, but we will have to wait for another year to see the true annual picture.

In the meantime, as the anniversary of the Review’s publication approaches, we await the Government’s White Paper to set the direction for reform of the Mental Health Act. These latest figures make it clear that we can’t afford to wait much longer.