On Friday 26 June an experienced panel and a select group of mental healthcare professionals including AMHPs, psychiatrists and nurses got together with service users and those with lived experience over Zoom to discuss and debate digitising the Mental Health Act (MHA) #DigitalMHA.

Following the 2018 Review of the Mental Health Act there has been growing acceptance that the Act requires digitisation.

Indeed, it was one of the recommendations of the review itself. Digitisation however is not as simple as perhaps it first seems. It is possible to replicate the existing paper forms digitally, but does that miss the point?

Digitisation presents a huge opportunity for care quality improvements, but it also presents risks. As a values-led organisation and due to the acceleration in digital as a result of COVID-19, Thalamos wanted to hold an interactive debate about the opportunities, challenges and risks associated with digitising the MHA.

You can catch up on the debate by following #DigitalMHA on Twitter or watching the video catchup.

The debate – What are the opportunities and risks associated with digitising the Mental Health Act?

The topic sparked a vocal, but healthy debate. It was great to have so many people participate and also to hear so many points of view. Here are the main issues raised:

We need to fix the Mental Health Act before we digitise it

Most concerns were around the current process of detainment. Firstly, there is a lack of facilities and resources: One AMHP reported how he had just that week sectioned someone in Manchester who was transferred to a hospital in London because that was the nearest available bed. The legal framework is also disparate and unclear, making it harder for professionals to do an already tough job. Then on top of a difficult decision to section someone, is then the practice of actually detaining them against their will and the upset it causes the individual, carer and professional.

It was proposed that digitisation could potentially help us make better informed and thought-through decisions. Furthermore, it could provide better resources and explanation to the service user to help them understand their rights and what is happening to them. The experience is never going to be nice, but it can be made less unpleasant.

We need to put the individual, not the professionals, at the centre

Many felt that digitising the Mental Health Act was more about making it easier for professionals and questioned how it would actually help service users. Digitisation would need to take a bottom-up approach and involve all stakeholders ranging from doctors, nurses and administration staff to carers and service users.

Digitising the MHA would foremost streamline the process to help the professionals perform their role more swiftly and more efficiently. The service user’s experience wouldn’t necessarily become more digitised. It was agreed that if technology were to be used it must make the process more human, not less.

Currently not enough is being done to involve underserved marginalised and ethnic minority groups in consultation. Often there is disparity in how they are treated compared to other groups. Also, could the addition of technology further alienate these more vulnerable groups?

“Digitisation must help data quality improvement” Dr Geraldine Strathdee, OBE

Not enough data collected is currently being used, which has a detrimental impact on how mental healthcare professionals do their job and, in turn, treat individuals in need. Surely technology can assist us in the better collection, sharing and standardisation of data? So that we can make better use of it, especially with regards to ethnicity. Technology should be used as an enabler, it should never be used to make the process less human. Arden Tomison, Founder of Thalamos cited that digitising the Mental Health Act was pointless unless it resulted in marked improvements to its current form.

Dealing with data also brings about concerns of security. If you sent confidential information to an inbox, who would actually be picking up the email? Furthermore, if the data is then saved to a local records system, could the information stored be accessed without consent? Conversely, how protected is the information in the current paper forms being transported via the Royal Mail and in ambulances with patients on their way to hospital?

Digital will enable a reduction in errors and an increase in efficiencies

By digitising the current paper-based system it was felt that there would be an improvement in service delivery and a reduction in errors. Shared decision making would become much simpler and it would allow note sharing across boundaries. However whilst digitisation would make coordination easier for all parties involved, not all parties have access to the technology needed, namely AMHPs.

If all the technology can be lined up, then digitisation will have a huge impact on reducing a really drawn out process. Currently “it’s about waiting. Waiting for an ambulance, waiting to get the information, waiting for the police…By the time someone is admitted it could be several hours or even several days later” Carla Fourie said. Completing and sending forms digitally will enable patients swifter access to care. Quicker access to care will be safer for both the patient and their families.

In summary

Many of the group felt digitising the Mental Health Act could contribute to a more efficient and streamlined process and subsequently improve the experience of individuals. Some contributors understandably had reservations and were afraid using devices would make the service less human and could present security risks. There was an overwhelming desire to fix the MHA with some of the major issues concerning exclusion of underserved groups, underuse of data and putting the individual at the centre of the process.