Bipolar UK cautiously welcomes the Modernising the Mental Health Act – final report from the independent review published on Thursday 6th December 2018. Being detained and treated under the Mental Health Act is sadly an experience familiar to many people living with bipolar.

Detainment done well can play a key role in someone’s recovery. Detainment done badly can result in long term psychological damage and occasionally even physical injuries. For people on an acute ward, their experience too often exacerbates the mental illness that brought the person into inpatient care in the first place.

The recommendations, produced by Prof Sir Simon Wessely and his team, are a positive step to re-balance the system to be more responsive to the wishes and preferences of the patient. We believe they would improve the ability of people with bipolar to make decisions about their own care and treatment.

Key recommendations include:

• Introducing Advance Choice Documents (ACDs) in which people with bipolar would be encouraged to voice their views about future inpatient care and treatment
• The right to advocacy based on an opt-out rather than opt-in basis and extended to people who are informally admitted
• Replacing ‘nearest relative’ with a ‘nominated person’
• That police cells no longer being used as ‘Places of Safety’ for anyone of any age
• New capital investment to modernise the NHS mental health estate to improve inpatient environments
• Creating Organisational Competency Framework (OCF) to tackle racial disparities in detainment

Stigma in healthcare settings

While welcoming these recommendations, Bipolar UK would like to reiterate that the NHS needs to take a zero tolerance approach to the abuse of patients by staff, while increasing the time nurses spend on wards providing direct support to patients. Stigma, towards oneself as well as within families, is very prevalent, so it is absolutely vital that NHS staff do not stigmatise patients under their care. We would like to stress the importance of involving the ‘nominated person’ and/or friends and family in the care planning process, particularly on release from hospital. Spending time in a secure psychiatric unit, either informally, or being detained, can play an important role in someone’s recovery. Improving the quality of that experience and reducing the stigma attached to it, as well as maximising the chances of full recovery after release, should be a priority alongside the reform of the act itself. 

In line with the recommendation that further research be conducted on different approaches to reducing detention; Bipolar UK will be evaluating its own peer support services, to explore the role we can play in reducing the number of people living with bipolar who are detained or who are re-admitted after being discharged.

We would particularly like to look at our provision of voluntary opportunities because it is important people with a bipolar diagnosis who are recovering from an episode to have a structure to their day, a sense of purpose and identity, and a reason to get up in the morning.

The full report can be found here

Simon Kitchen

CEO, Bipolar UK

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