Doing it right – the Code for treatment of mental health illness

The Government reports 2,726,721 people had contact with NHS secondary mental health services in the period 2018/19 – about 4% of the population of the UK.  

If you take out the under 18s (632,261), and the elderly (340,040 – a high proportion of whom will require help because of dementia), this leaves 1,752,420 adults between 18-80.

That is a lot of demand for NHS mental health services.      

The Code of Practice relating to the Mental Health Act 1983 – the law governing how mental health services are provided – has a set of first-class principles.  One is headed “Efficiency and equity”.   

Under this heading is this statement: “Commissioners and providers, including their staff, should give equal priority to mental health as they do to physical health conditions” (1.18).  

This principle is to be applauded.  But experience suggests you can applaud all you like, the truth is, priority is not given equally to commissioning and providing mental health services.  

This version of the Code was published in 2015.  5 years later, we all know resources remain woefully inadequate with respect to the provision of mental health services – but that issue is for another post.  

For the purposes of this post, I’d like to talk about the principles of the Code, which, if they were applied, would transform the provision of mental health services.  

The principles of the Code are:

  1. Least restrictive option and maximising independence – “restrictions should be the minimum necessary to safely provide the care and treatment required” (1.5).
  2. Least restrictive option and maximising independence – “restrictions should be the minimum necessary to safely provide the care and treatment required” (1.5).
  3. Least restrictive option and maximising independence – “restrictions should be the minimum necessary to safely provide the care and treatment required” (1.5).
  4. Least restrictive option and maximising independence – “restrictions should be the minimum necessary to safely provide the care and treatment required” (1.5).
  5. Least restrictive option and maximising independence – “restrictions should be the minimum necessary to safely provide the care and treatment required” (1.5).

The status of the Code is not the same as the Mental Health Act 1983.  However, the Code does state that if it is not followed this could have legal consequences.  

Even though the principles are aspirations, they are the core of the Code.  And the Code is about how people are to be treated who come to the mental health services because of need.  

Yes, the principles are aspirations for best practice, but people who have need are experiencing mental torment in some form, otherwise they would not be seeking help.   

If a patient is detained longer than necessary, or not consulted about their care plan, or not treated with dignity or respect, or the treatment needed is not available, or the provider does not have the skills required to assess and provide the treatment, if the principles of the Code are breached, this can be the beginnings of a clinical negligence claim.  

If we can help you to investigate a possible case relating to your mental health treatment, email or call – 

jholtom@lspartnership.co.uk

john@freemanharris.co.uk

Or all the Dunstable office 01582 417208

Or call Talha in the London office 0207 790 7311

John Holtom, Consultant Solicitor, specialist in Clinical Negligence and Serious Personal Injury claims for 30 years. 

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