In November 2016 the Care Quality Commission (CQC) published their annual report on the monitoring of the Mental Health Act (MHA) in England. At the time of publication statistics on the use of the MHA were not yet available, but they were finally published at the end of November:
“The total number of detentions under The Act continued to rise, increasing by 9 per cent to 63,622 compared to 58,399 detentions in 2014/15”.
On page 18 of the CQC there is a diagram showing the increasing use of detention under the MHA from 2008/2009 to 2014/2015. In the first year detained patients accounted for fewer than 30 per cent of admissions (I think they are referring to admissions, although it is not absolutely clear). By 2014/15 they account for over half. And presumably that proportion has increased further with the latest statistics.
As far as ECT is concerned, patients treated without consent under the MHA continue to make up an increasing proportion of all ECT patients. The use of ECT on consenting patients is declining but its use on non-consenting patients (under current legislation that is restricted to patients who are deemed incapable of making decisions over treatment) is not showing a similar decline. In their previous annual report the CQC noted that the numbers of people being treated with ECT without their consent were actually rising.
“To explore possible reasons for this change, we will be looking more closely at our national data on ECT second opinions, for example to see whether there are regional differences and will discuss our findings with the Department of Health.”
Whatever the outcome of the discussion, they have not mentioned it in the 2015/2016 report.
The number of requests for authorisation of ECT on a non-consenting patients is almost exactly the same as last year – 1627 requests this year compared to 1631 last year. The report does not say in how many cases authorisation was not given; in 2014/2015 it was withheld in just under 5 per cent of requests.
The CQC also approved four psychosurgical operations, the same number as last year. (Psychosurgery can only be carried out with the consent of the patient and the approval of the CQC). Two of the operations were on people who had had a previous operation.