Monitoring the Mental Health Act 2019/20

With all the kerfuffle around two recent White Papers you might have been forgiven for not having the chance to digest CQC’s annual report, published last month.

This one is slightly different to previous ones in that it has a specific focus on the impact that Covid-19 has had on patients / the services that care for and treat them.

They wanted to share the learning from the initial stages of the pandemic with providers, staff, system stakeholders and policy makers so it can be applied as quickly as possible in the current wave – and any possible resurgence.

Chapters 1 – 5 set out their findings during the pandemic. These are based on over 355 remote monitoring exercises carried out from April – October 2020.

They cover:

• What patients and carers told them about the impact of the pandemic
• In-patient services’ preparation for the pandemic
• Preventing and controlling the spread of Covid-19
• Preserving least restriction, respect and dignity
• Deaths of detained patients

Chapter 6 of the report sets out their more usual data from monitoring activity before the pandemic. Data from monitoring and other activities in 2019/20 is to be further analysed and will be discussed in their next annual report.

In the summary they list seven actions they want to see to support people subject to detention under the MHA:

1. It is vital that discharge planning is carried out in co-production with patients and their families/support networks in order to ensure better outcomes.
2. Patients must be involved in decisions about their care, including infection control. Where this is done, the negative impact of restrictions on detained patients during a pandemic can be limited.
3. Modernising physical estates would help with infection control measures.
4. Services should recognise the significant impact restrictions on leave of absence and activity can have on detained patients and ensure these are lifted as quickly and as safely possible to avoid very damaging ‘closed cultures’ from emerging.
5. Relaxing the rules around using personal technology, such as mobile phones, should continue in future, and services should prioritise linked issues such as WiFi connectivity in future estates development.
6. Advocacy should move to be offered on an opt-out basis in future.
7. There needs to be careful evaluation of using remote technology should aspects of them continue after the pandemic abates.

These are certainly topics that have come up in discussion with our mental health clients in both the public and private sectors.