Research into the Mental Health Act: a qualitative study of the views of those using or affected by it

Background : Britain's existing mental health legislation was introduced over 15 years ago. Since then, there has been considerable reorganisation of mental health care services but little research into the use of the Act in routine practice. Modernising Mental Health Services (1998) asserts that mental health legislation will be revised. Aim : The study investigates opinions about the strengths and weaknesses of Parts II and X of the Mental Health Act (1983) of those affected by it. Method : Those affected by the Act were separated into three groups: (1) those directly and commonly involved with the Act (mental health nurses; approved social workers; general psychiatrists; MHA administrators; service users; their carers);(2)those less directly affected (hospital managers; lawyers; general practitioners; policy makers; police surgeons and liaison officers; specialist psychiatrists); (3) organisations representing Groups 1 and 2. A range of qualitative research methods was used to gather data. Views expressed were systematically coded to triangulate findings across the study. Results : Eighty-two individuals participated and nine major issues were generated across study participants. These covered concerns about the appropriateness and effectiveness of existing commitment criteria and procedures, inadequate knowledge and understanding of the Act among professionals as well as patients and carers and the appropriateness of the statutory roles, including the Nearest Relative. Conclusions : The findings provide a valuable insight into views about how existing legislation is applied in practice. These suggest that a review of criteria and procedures for commitment is needed. More effective implementation of legislative policies and the reconfiguration of resources to support them are also needed.