Our aim at the Institute for Mental Health is to improve care and outcomes for young people suffering from mental ill health, and as such we welcome the focus and debate. The time does seem right to reconsider the Mental Health Act, as the public dialogue about mental illness is quite different now to when the Act was last amended in 2007. The recommendations to come out of this review appear sound and well intentioned, and fewer detentions would seem a useful aim, especially lowering the use of community treatment orders, for which there is little evidence of effectiveness.
There are definitely improvements to be made with the current Act which emphasises risk management above everything else. This can set the tone for admissions. For physical health problems the emphasis is on capacity and consent to treatment and best care.
However, we are also mindful that experiences of care are not solely governed by the Act – they are a function of funding, training, and care capacity within hospital wards. Staff want to provide excellent care but the stresses on hospital wards, including the numbers of people who are admitted, the short durations of admission, and how unwell people are at these times, will mean improving care will remain a challenge without better funding. Better investment in early intervention and community services, and not only crisis care, may be one way to reduce detentions, especially for young people.