A prospective, quantitative study of mental health act assessments in England following the 2007 amendments to the 1983 act: did the changes fulfill their promise?

Abstract

BackgroundIn 2008, the Mental Health Act (MHA) 2007 amendments to the MHA 1983 were implemented in England and Wales. The amendments were intended to remove perceived obstacles to the detention of high risk patients with personality disorders (PDs), sexual deviance and learning disabilities (LDs). The AMEND study aimed to test the hypothesis that the implementation of these changes would lead to an increase in numbers or proportions of patients with these conditions who would be assessed and detained under the MHA 2007.MethodA prospective, quantitative study of MHA assessments undertaken between July–October 2008–11 at three English sites. Data were collected from local forms used for MHA assessment documentation and patient electronic databases.ResultsThe total number of assessments in each four month period of data collection varied: 1034 in 2008, 1042 in 2009, 1242 in 2010 and 1010 in 2011 (n = 4415). Of the assessments 65.6% resulted in detention in 2008, 71.3% in 2009, 64.7% in 2010 and 63.5% in 2011. There was no significant change in the odds ratio of detention when comparing the 2008 assessments against the combined 2009, 2010 and 2011 data (OR = 1.025, Fisher‘s exact Χ 2 p = 0.735). Only patients with LD and ‘any other disorder or disability of the mind’ were significantly more likely to be assessed under the MHA post implementation (Χ2 = 5.485, P = 0.018; Χ2 = 24.962, P > 0.001 respectively). There was no significant change post implementation in terms of the diagnostic category of detained patients.ConclusionsIn the first three years post implementation, the 2007 Act did not facilitate the compulsory care of patients with PDs, sexual deviance and LDs.

Clinical and social factors associated with involuntary psychiatric hospitalisation in children and adolescents: a systematic review, meta-analysis, and narrative synthesis

“…This is interesting from a UK perspective because one of the amendments to the Mental Health Act in 2007 was designed to make it easier to involuntarily admit people with personality disorder who were thought to be at high risk. 63 However, only one of the studies that included data on personality disorder in this review came from the UK, and this study was published before 2010. The studies included in this review do not describe how risk is assessed and reported in children and adolescents and how this might influence decisions about the legal status of admission.…”

Current understanding of the impact of climate change on mental health within UK parliament

“…There has been significant legislation passed by the houses of UK parliament on both climate change and mental health as separate critical challenges. The Mental Health Act was passed in 2007 and the Climate Change Act was passed in 2008, with amendments such as Net Zero 2050 made more recently (22)(23)(24). However, it is unclear to what extent UK decision-makers are considering the intersections between these critical issues and whether discussions are framed with reference to synergistic policy solutions.…”