Deaths of Patients Detained under the Mental Health Act (MHA)
This project is led by Simon Armson, who initially undertook scoping work to identify the key work priorities for the IAP in relation to the deaths of those detained under the MHA, to take forward as part of the longer-term work programme.
There were 3,810 deaths of detained patients between 1999 and 2009. These account for approximately 60% of all deaths in state custody. The Panel recognises the work that has already been undertaken to reduce suicide in this patient group, including the development of the National Suicide Prevention Strategy. In this context, the Panel decided to focus on natural cause deaths, particularly those that could be viewed as premature.
Simon presented findings and recommendations about how to address evidence of poor physical health of mental health patients to the Ministerial Board in March 2011. He is working with Department of Health, Care Quality Commission and other stakeholders such as the Health and Social Care Information Centre to progress recommendations aimed at understanding the reasons for the high number of deaths from myocardial infarction and pulmonary embolism. A re-analysis of the statistics is expected in September 2012. This project aims to ensure there is sufficient focus on improving the physical health of detained patients, both strategically from the new NHS Commissioning Board and in delivery for patients on admission and discharge from mental health settings.
The Panel has been developing its engagement with Third Sector and NGOs as well as practitioners with an interest in detained patients and also attends the Bradley Group –organisations which come together to support and encourage implementation of the Bradley Report.
Later in 2012, Simon will also be commissioning a literature review to understand, more specifically, how mental disorder amongst detainees relates to self-inflicted deaths and natural cause (albeit unexpected) deaths in all custodial settings. He is also working with Professor Philip Leach and Deborah Coles on ideas for researching the quality of investigations undertaken on deaths of detained patients.
Terms of Reference
- Review the statistics on the number of deaths of detained patients over the last ten years in order to gain an understanding of the scale of the issue and identify any common themes.
- Undertake a short analysis of relevant data and information sources including narrative verdicts and Rule 43 Reports, data from the Care Quality Commission (CQC), the National Patient Safety Agency (NPSA) and the Confidential Enquiry into Suicides and Homicides by People with Mental Illness to identify any gaps and priority areas for the work of the IAP.
- Seek the views and advice of relevant organisations and individuals with experience of dealing with deaths of this nature.
- Use the findings of this work to produce outline recommendations for the preparation of advice and guidance for those responsible for the care of detained patients, which will be developed as part of the IAP’s longer-term work programme.