In place of fear?: the Mental Health Act Commission eleventh biennial report 2003-2005 - Tapa blanda

This is the 11th biennial report by the Mental Health Commission on its activities in monitoring the operation of the Mental Health Act 1983 and reviewing the lawfulness of detention of detained patients. This report covers the financial years 2003-04 and 2004-05 and focuses on issues of security and care. Topics discussed include: findings in court case judgements (including the 2004 European Court of Human Rights judgement in HL v United Kingdom) and the use of legal powers in relation to civil detention and the criminal justice system, staffing and resources issues, devolved service commissioning and the impact on specialist provision, the concept of patient choice, equality issues, the detention and monitoring of mentally disordered persons and offenders, deaths of detained patients and seclusion incidents, Second Opinion activity, and the implications of the forthcoming Mental Health Bill.

Based upon the MHAC's visits to detained psychiatric patients in all hospitals in England and Wales between 2003-2005, the report sets out the MHAC's observations and concerns about current and future mental health care involving compulsion. It calls for measures to break the 'circles of fear' that may contribute to avoidable use of coercion in mental health services. One of the questions raised by the authors is whether "all inpatient mental health services provide their patients with acceptable levels of security, care, or a sense of someone who matters." The report goes on to discuss aspects of the use of present mental health powers in relation to civil detention and police powers, and includes an extended discussion on the detention of mentally disordered offenders. It provides analysis of deaths of detained patients; seclusion incidents notified to the Commission; and Second Opinion activity during this period.