Intended for healthcare professionals


Work of mental health review tribunals is increasing faster than detentions

BMJ 1999; 319 doi: (Published 02 October 1999) Cite this as: BMJ 1999;319:920
  1. G E Langley, medical member, mental health review tribunals, south and west (gdlangly{at}
  1. Hanningfields, Warborough Hill, Kenton, Exeter, Devon EX6 8LR

    EDITOR—Wall et al provide a helpful outline of the significant increase in all psychiatric admissions and in those admitted under the Mental Health Act 1983.1 They mention, but do not document, the effect of these trends on mental health review tribunals.

    My study shows that the rate of appeals to, and hearings by, mental health review tribunals is increasing faster than increases in the episodes of detention that warrant a tribunal application. During 1991-3 the number of episodes of detention rose by 4245 (15% of 1991 total), the number of appeals to tribunals by 2032 (29%), and the number of hearings by 952 (26%). The episodes of detention include not only those admitted to hospital under the act but also those inpatients who were converted from another status to an episode of detention that presented the opportunity for an appeal or further appeal—for example, a conversion from informal to section 2 or 3, or from section 2 to section 3. Thus not only has the proportion of psychiatric inpatients that are detained under the act risen but so has the proportion of those detained who appeal to and are heard by tribunals.

    I also observed considerable differences between NHS regions in the rate of detention per unit of population. The figure shows the rates of detention under section 2 and subsequent appeals. Detentions under section 3 showed a similar trend. Consequently, the burden of arranging and manning tribunals will vary between regions.


    Rates of detention under section 2 of Mental Health Act 1983 and appeals to mental health review tribunals per 1000 population of NHS regions, 1994-95


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