Changing patterns in the use of the Mental Health Act 1983 in England, 1984-1996

Background The Mental Health Act 1983 (MHA) is due to be revised by Parliam ent in the near future. Aims To explore changes in the use of the Act since its introduction. Method The Department of Health and the Home Off ice routinely collect data on the numbers of patients admitted to psychiatric hospitals under the MHA . We present absolute figures. by year. for the total numbers admitted unde r each section of the Act; We used the total psychiatric hospital admission s and total prison populations as denominator data. Results Formal admissions rose from 16 044 in 1984 to 26 308 in 1996, a 63% increase. Admissions under the MHA have increased as a proportion of ail a dmissions. The increase is mainly accounted for by changes in the use of Pa rt ii of the Act, in particular sections 2 and 3. The use of forensic secti ons (Part III) has also increased, with a marked increase of sections 47 an d 48. Use of Part X of the Act (sections 135 and 136) declined in the late 1980s but rose again in the 1990s. Conclusions Formal admissions are more common than they were in 1984, despi te there being fewer psychiatric beds. This is probably due to changes in t he provision of psychiatric services, and changing societal pressures on ps ychiatrists away from libertarianism and towards coercion. Declaration of interest Funded by the Department of Health.