RCN responds to publication of the report of the Independent Review of the Mental Health Act
RCN Professional Lead for Mental Health Catherine Gamble said:
“While there are some welcome points from this review, notably strengthening the right of people detained to meaningful appeal, we doubt this will provide comfort to communities particularly affected by disproportionate rates of detention. Nurses, the largest and most diverse professional group in the mental health workforce must be tapped into to support, represent and advocate for BAME patients who, as this report highlights, are the most likely to be detained under the Act.
“The experience of people detained under mental health legislation would improve by extending the role of nurses, providing clear direction on the extent of nurses’ holding powers and addressing the varying quality of education mental health nurses receive on mental health legislation. These changes must work in tandem with improvements to broader infrastructure which must be carried out as a matter of urgency namely the abolition of community treatment orders and fusing the Mental Capacity and Mental Health Acts.
“The report comes at a time when mental health services are struggling to cope with chronic staffing shortages – 14.3 per cent of mental health nursing posts are vacant – and a high turnover of staff as a result of the pressurised working environment in mental health trusts referred to in damning CQC reports. Not being able to roster staff effectively has a knock on effect that prevents nurses from attending mental health tribunals or stopping nurses from receiving the quality education they need to adhere to the Mental Health Act or wider human rights and detention concerns. It’s disappointing the report didn’t tackle the issue of safe staffing head on but it’s an issue the RCN will continue to raise with the Government and the NHS in England.
“While the RCN has been involved throughout this process, our members will perhaps wonder whether their advice was truly considered as the recommendations here are less than radical.
“One particular missed opportunity for the report was to address the shortfall in emergency departments where it’s been difficult to manage people in distress at risk of harming themselves or others who have not been assessed regarding detention or refuse to take any part in any assessment. Our members are concerned about a lack of guidance for emergency department staff, psychiatric liaison teams and hospital security on how they can maintain a patient’s safety and alleviate their distress. It’s not enough to simply note A&Es are overstretched, and human rights will continue to be breached on a daily basis in emergency departments until this is confronted.
“Nurses had hoped this report would empower clinicians and allied health professionals to act more autonomously, reduce barriers to patients receiving a seamless service and prove to nurses they’re a valued aspect of the system that cares for our most vulnerable and severely mentally ill. It’s difficult to see how this report will enable that.”