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Monitoring care & treatment

Our current monitoring priorities

As well as producing general monitoring and trend data on the use of Mental Health and Incapacity Acts, we also produce special reports on areas of care and treatment where we have particular concerns. Our current priorities are:

Children and young people under 18

The principles of the Mental Health Act say that the welfare of children and young people under 18 should be of paramount concern to those providing mental health care and treatment. Children and young people should not receive care and treatment in adult mental health or learning disability settings.

We have concerns about services provided to children and young people. Too many children and young people are admitted to adult wards. These are not appropriate places for young and vulnerable people to get the treatment and support they need. Even in areas where there is specific provision for in-patient services, young people are being admitted to adult wards. We are collecting information so that we can report in more detail on the care and treatment of children and young people.

Individuals who have been detained long-term

We are concerned that the needs of people who are detained for long periods of time are not being addressed as they should be. We are concerned that the principles of the Mental Health Act are not being fully considered in relation to this group. We have particular concerns about the limited evidence of positive, recovery-focused management of individual care for patients who have been detained for a long time. We will be monitoring people who have been detained for more than three years to get a better picture of their care and treatment.

Individuals who are subject to short-term detention certificates (STDCs)

Prior to 2005, under the old Mental Health Act, the Commission used to have a role in reviewing and revoking short term orders. We used to be contacted by people, who wanted us to review their care and treatment, with a view to revoking their order. While we rarely found a reason to revoke an order, this function brought us into very regular contact with people who were acutely ill. This contact often highlighted other issues in that person's care and treatment that we would follow up on. Since 2005, we have not seen significant numbers of people who are on STDCs as part of our standard visiting programme. We are concerned that the use of STDCs varies across the country. We want to look at the circumstances surrounding an individual's detention under an STDC to highlight differences in practice and any concerns this may raise for people providing and using services.