Intellectually elite are more likely to appeal

EDITOR,—Caroline Bradley and colleagues' conclusions concerning appeals against detention under section 2 of the Mental Health Act are limited since no comment is made about the inclusion of patients with learning disability and mental illness, which could appreciably alter the data.1 The finding that those educated to A level standard are more likely to appeal is interesting but not surprising and may reflect a bias in favour of the intellectually elite. Patients who do not understand the process of appeal because of mental illness or intellectual handicap, or both, cannot be expected to appeal. We agree with the authors' conclusion that the current procedure does not protect the civil liberties of all patients.

Clearly, the system of appeal against detention needs to be reviewed. The rate of discharge as a result of appeals is low2; the current system is expensive to operate; and, as Bradley and colleagues' paper suggests, the process inadvertently discriminates against those it is intended to help. Perhaps a fairer system should be implemented, in which all those detained under the Mental Health Act are automatically reviewed by a local independent body with psychiatric input.