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 2019Alice 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 SearchCompulsory 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 findingsAssessments 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.
ConclusionSome 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.
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