Trends in the use of Part II of the Mental Health Act 1983 in seven English local authority areas.

BACKGROUND Data collected by the Department of Health show a continuing increase in the rate of formal detention in hospital under Part II of the Mental Health Act 1983. AIMS To establish whether the increase in formal detentions is uniform across subgroups of the population. METHOD Data related to use of Part II of the Act between 1991 and 1997 collected by seven English local authorities were examined. Rates of compulsory admission were standardised to age, gender and ethnicity-specific populations. RESULTS Over the 8-year period the overall rate of detention under Part II increased by 32%. It increased in all three major ethnic groupings; the rate of increase was greater for men than for women (38%v. 26%) and, in particular, for younger men compared with younger women (43% v. 28%). CONCLUSIONS A combination of factors probably accounts for these findings, including service factors (particularly reduction in bed numbers), a culture of risk aversion, and changes in the effect of substance misuse on the presentation of mental illness.