Putting mental health at the top of the agenda

by Tim Gunning

Published: 14 May 2018

One in four adults struggle with it every year, an estimated three quarters of people don’t receive any support for it, and it costs the economy an estimated £105 billion a year.

It’s time we really talk about mental health.

Each year, Mental Health Awareness week brings mental distress to the fore, encouraging those who may be struggling, to seek help. It also serves as a reminder that it’s good to talk about mental health, and we should talk about it more openly.

From securing more funding for mental health services, to ensuring that everyone receives appropriate support, there’s so much more to be done before mental health is on an equal footing with physical health.

This week we’re helping to raise awareness and calling for the need to deliver early interventions and effective treatment that is timely, accessible and close to home.   

When people cannot access the support they need, they may reach a crisis point and can become subject to involuntary treatment under the Mental Health Act (MHA). This can include the use of highly coercive treatment such as detention, restraint, seclusion and enforced medication, which may breach their human rights.

We’ve recently spoken to three individuals about their experiences of detention under the MHA, and their shocking and moving tales are eye-opening.

Rafik's story

Raf told us how he experienced restraint, enforced medication, solitary confinement and discrimination when being detained under the MHA. This not only breached his rights to freedom, autonomy, religious expression and freedom from degrading treatment, but it also had a detrimental impact on his mental health.

Laura's story

As a young person, Laura was detained in a hospital far away from her family. In her video, she explains the impact this isolation had on decisions about her treatment and her recovery. She also tells us how good support from community mental health services has enabled her to move on with her life in a positive way.

Richard's story

Richard, whose son David died following his discharge from hospital, explained the damning findings of an investigation into the failings of the NHS Mental Health Trust responsible for his son’s care. With more effective planning and aftercare, more could have been done to prevent his death.

Reform is needed

These three stories highlight the clear need for comprehensive reform of the MHA and its coordination with wider mental health services.

There needs to be a greater emphasis placed on people’s rights to determine their own treatment and care options, and to ensure that everyone is treated with dignity and respect.

Throughout 2018 and 2019, our work will continue to demonstrate how mental health services need to change to improve equality and human rights protections for everyone. Services need to respond in a coordinated and joined-up way to better meet the mental health needs of everyone and we will be pushing for this to happen.   

From undertaking comprehensive analyses into how effectively mental health services are meeting the needs of different people, to working with the UK government to improve access to early interventions for children and young people; and from funding innovative new work to understand how to improve access to talking therapies for protected groups, to looking into how to tackle the overuse of restraint, we have brought Britain’s mental health to the top of our agenda.

Independent review

This is all underpinned by the work we’re doing to influence the independent review of the MHA.

The review provides an opportunity to achieve real change, and we have highlighted a range of concerns to them, including:

  • that many people do not receive the mental health support and treatment they need and that this impacts on the numbers reaching crises
  • increasing numbers of people are being detained under the Mental Health Act
  • stark disproportionalities in use of the Mental Health Act, such as Black people being four times more likely to be detained under the Act than other groups and up to 9 times for the use of community treatment orders
  • many treatment environments are not safe or therapeutic and potentially breach the basic human rights of their patients
  • too little weight is being given to the views of patients in determining their own treatment
  • many patients are not getting access to independent advocacy
  • there is a need to review the provision of accessible information for patients about their rights and treatment as people are not always being informed of their rights when they are detained

It is promising to see that the independent review is prioritising work in these areas and that it is committed to engaging with people with lived experience of the MHA.

We’re hopeful that its findings and recommendations will spur on the UK government to ensure people who need support with their mental health, receive the appropriate service that respects and protects their human rights and provides better care in the community. We will continue to gather evidence to support the review, to develop practical solutions to the problems experienced by all service users.

However, any reforms which the MHA Review proposes are unlikely adequately to address the crucial issue of the vast number of people who are unable to access the support and treatment they need for their mental health.

More funding, a stronger focus on providing care in the least restrictive way possible, and services that are better able to identify and meet the needs of all their patients, are essential.

There is no doubt that mental health is on the UK’s agenda, but we have a long way to go before everyone is able to attain the highest possible standard of mental health, without delay or discrimination.