The Mental Health Act Assessment Process and Risk Factors for Compulsory Admission to Psychiatric Hospital: A Mixed Methods Study

Correspondence to Alice Wickersham, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, 16 De Crespigny Park, London, SE5 8AF, UK. E-mail: alice.wickersham@kcl.ac.uk

Search for other works by this author on: Shilpa Nairi , Shilpa Nairi Camden and Islington NHS Foundation Trust , 4 St Pancras Way, London, NW1 0PE, Search for other works by this author on: Rebecca Jones , Rebecca Jones Division of Psychiatry , University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, Search for other works by this author on: Brynmor Lloyd-Evans Brynmor Lloyd-Evans Division of Psychiatry , University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, Search for other works by this author on:

The British Journal of Social Work, Volume 50, Issue 3, April 2020, Pages 642–663, https://doi.org/10.1093/bjsw/bcz037

11 April 2019 19 February 2019 11 April 2019

Cite

Alice Wickersham, Shilpa Nairi, Rebecca Jones, Brynmor Lloyd-Evans, The Mental Health Act Assessment Process and Risk Factors for Compulsory Admission to Psychiatric Hospital: A Mixed Methods Study, The British Journal of Social Work, Volume 50, Issue 3, April 2020, Pages 642–663, https://doi.org/10.1093/bjsw/bcz037

Navbar Search Filter Mobile Enter search term Search Navbar Search Filter Enter search term Search

Abstract

Background

Compulsory admission rates under the Mental Health Act (MHA) have been on the rise for many years despite representing a costly and coercive approach to psychiatric care. There is therefore an urgent need to minimise compulsory admission rates using interventions based on known risk factors for detention. However, risk factors in the MHA assessment process have been under-researched.

A mixed methods service evaluation was conducted in one inner London NHS Trust. A retrospective cohort study used routinely collected assessment records to model potential risk factors for detention. Local assessors were interviewed to explore factors that might help or hinder detention minimisation.

Main findings

Assessments were less likely to result in detention when professionals other than the assessing team were in attendance, although this association weakened after adjusting for potential confounders. Interviewed assessors identified factors that could contribute to detention minimisation in the assessment process, in general service provision, and in wider society.

Conclusion

Some local assessment processes could contribute to minimising detention rates, such as community team participation in assessments. Challenges posed by limited resources and community and inpatient care were particularly evident. Consideration of these might also help reduce detentions.

© The Author(s) 2019. Published by Oxford University Press on behalf of The British Association of Social Workers. All rights reserved.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

You do not currently have access to this article.

Sign in

Personal account

Institutional access

Institutional account management

Get help with access

Institutional access

Access to content on Oxford Academic is often provided through institutional subscriptions and purchases. If you are a member of an institution with an active account, you may be able to access content in one of the following ways:

IP based access

Typically, access is provided across an institutional network to a range of IP addresses. This authentication occurs automatically, and it is not possible to sign out of an IP authenticated account.

Sign in through your institution

Choose this option to get remote access when outside your institution. Shibboleth/Open Athens technology is used to provide single sign-on between your institution’s website and Oxford Academic.

  1. Click Sign in through your institution.
  2. Select your institution from the list provided, which will take you to your institution's website to sign in.
  3. When on the institution site, please use the credentials provided by your institution. Do not use an Oxford Academic personal account.
  4. Following successful sign in, you will be returned to Oxford Academic.

If your institution is not listed or you cannot sign in to your institution’s website, please contact your librarian or administrator.

Sign in with a library card

Enter your library card number to sign in. If you cannot sign in, please contact your librarian.

Society Members

Society member access to a journal is achieved in one of the following ways:

Sign in through society site

Many societies offer single sign-on between the society website and Oxford Academic. If you see ‘Sign in through society site’ in the sign in pane within a journal:

  1. Click Sign in through society site.
  2. When on the society site, please use the credentials provided by that society. Do not use an Oxford Academic personal account.
  3. Following successful sign in, you will be returned to Oxford Academic.

If you do not have a society account or have forgotten your username or password, please contact your society.

Sign in using a personal account

Some societies use Oxford Academic personal accounts to provide access to their members. See below.

Personal account

A personal account can be used to get email alerts, save searches, purchase content, and activate subscriptions.

Some societies use Oxford Academic personal accounts to provide access to their members.

Viewing your signed in accounts

Click the account icon in the top right to:

Signed in but can't access content

Oxford Academic is home to a wide variety of products. The institutional subscription may not cover the content that you are trying to access. If you believe you should have access to that content, please contact your librarian.

Institutional account management

For librarians and administrators, your personal account also provides access to institutional account management. Here you will find options to view and activate subscriptions, manage institutional settings and access options, access usage statistics, and more.