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Trends in mental health review tribunal and hospital managers’ hearings in north-east London 1997-2007

Dhananjay Kumar Singh, Locum Specialist Registrar in General Adult Psychiatry

Goodmayes Hospital, Ilford, Essex

Joanna Moncrieff, Senior Lecturer

*Department of Mental Health Sciences, University College London, Gower Street, London WC1E 6BT, email: j.moncrieff{at}ucl.ac.uk

Declaration of interest

J.M. is co-chairperson of the Critical Psychiatry Network, a group of psychiatrists that has campaigned against the expansion of the remit of the Mental Health Act and D.K.S. is a member of this network.

AIMS AND METHOD

To examine trends in appeals to mental health review tribunals and hospital managers’ panels in a hospital covering two outer London boroughs from 1997 to 2007. Data were also used to explore associations between demographic variables, including ethnicity, and the results of appeal hearings.

RESULTS

The number of detentions under Mental Health Act Sections 2, 3 and 37 rose from 203 in 1996 to 279 in 2006. The percentage of these that went to appeal increased from 34% to 81% during the same period. However, there was no observed trend in the result of the appeals. The results were not associated with gender, ethnicity, marital status, age or the section involved; 12% of appeals were successful.

CLINICAL IMPLICATIONS

The study shows rising use of the Mental Health Act over the past 10 years and an increasing volume of appeals against its use. Since appeals are no more likely to result in discharge, the increased use of the Mental Health Act is not balanced by increased rates of discharge by review hearings. The study also demonstrates the rising workload for all involved in appeal hearings.




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