Women disproportionately affected by soaring Mental Health Act detentions

Other minority ethnic groups appear to have been disproportionately impacted in a handful of NHS Trusts. In Birmingham and Solihull, the number of Asian people detained increased by 30% from March to December 2020, to an average of 19 individuals per month. To put this into context, the number of white people detained in this trust rose by only 8%, to a monthly average of 41, during the pandemic. In South London and Maudsley, the number of mixed heritage individuals detained rose by 42% during the pandemic, to a monthly average of 6.4, compared with an increase of only 12% for white people.

Access to justice during the pandemic

The increases in detentions are reflected in exclusive data given to us by Mind. In comparison to the same month last year, February 2021 saw a 50% increase in calls to their legal support line relating to the Mental Health Act 1983.

For vulnerable people like Sophie, legal support may be crucial for understanding their rights in relation to their care and treatment – as well as whether they have a basis to appeal their detention.

However, openJustice and EachOther learned that access to justice has been an ongoing issue for sectioned patients since the start of the pandemic.

Gary Clarke, a lawyer specialising in mental health at Burke Niazi, has concerns that issues relating to COVID-19 have “seeped into decision-making” of mental health tribunals.

Patients may have their appeals rejected partly on the basis that they might not be able to comply with social distancing measures or because they won’t be getting the community support they require to keep them safe once discharged.

“This is an entirely new way of assessing a person’s mental stability and it’s dangerous territory,” Clarke told us.

Since the start of the pandemic, appeal hearings have been taking place online, causing problems for those without access to the internet, like patients who have been discharged but remain subject to Community Treatment Orders. Clarke described a client of his who phoned in for her hearing and, halfway through, was disconnected when she ran out of credit.

Online hearings also mean that the patient may not have had an opportunity to meet and develop a relationship with their advocate, which may lead to a decline in the quality of legal representation. For a very vulnerable person who may not clearly understand their circumstances, this relationship is key.

A spokesperson from the Department for Health and Social Care said: “We understand the last year has been challenging for the mental health and wellbeing of many, particularly those with pre-existing mental health conditions or severe mental illness.

“Mental health has remained a priority throughout the pandemic, with services remaining open for those who need them. We have increased support for those with severe mental illness providing an additional £50m for good-quality discharge from inpatient settings, 24/7 urgent helplines in every trust in England for those experiencing a crisis, and given an additional £500m for mental health and the NHS workforce as part of the spending review.

“In January we announced our plans to radically reform the Mental Health Act, empowering individuals to have more control over their treatment, tackling disproportionate detention of people from ethnic minority communities and ensuring those detained are treated with dignity and respect.”

The government’s public consultation, open until April 2021, will be an opportunity to ensure that people like Sophie, with lived experience of being sectioned, have their say on reforming the Mental Health Act.

“It’s crucial the UK government hears from people from different Black, Asian and other ethnic minority communities, to make sure any changes the Mental Health Act work equally well for people from different cultural backgrounds, as well as urgently tackling the underlying and systemic racism that results in disproportionate detentions and use of force,” Mind told us.

“We are concerned however that the UK government’s questions are complex and not very accessible, and so could act as a barrier to this. This is why we are working to demystify some of the main concepts and increase engagement so that more people have their voices heard.”

A key proposal in the white paper is to give legal weight to people’s choices and preferences surrounding their own care. As Sophie told us: “I felt powerless. Decisions were taken out of my hands, it didn’t feel right.”

To add your views on reforming the Mental Health Act you can use Mind’s tool. They will use the responses anonymously as part of their response to the UK Government. To download the full data set used for this investigation click here.

This story is part of our series The Unlawful State: Stories from a Pandemic where we investigate how the Coronavirus crisis has impacted on the most vulnerable in our society.

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