Bias and inequality were both key focuses of the 2018 independent review of the Mental Health Act. Those from minority groups were found to be disproportionately admitted to acute mental health care and affected differently by the system. For example, black people are currently four times more likely to be sectioned than white people. The disparity is glaringly clear. Bias within a safeguarding legislation acts like a gaping hole in a safety net: patients inevitably fall through.
We cannot allow bias and the negative effects it engenders to continue to exist within the Mental Health Act. As we modernise and reform, through both legislation change and digitisation, we need to address these areas of risk and eradicate them from the system. A modern mental health care pathway must be free from the dangers of bias and inequality. It’s time we make this a priority.
A series of statutory forms underpin decisions on patient admission, treatment and transfer within the Mental Health Act. Both the language and structure of these forms, and any accompanying documentation, has an impact on how these decisions are made. And this is where bias takes hold. If a form is designed around a singular patient demographic, the decisions it leads to can negatively or disproportionately affect those outside of this.
When digitising the Mental Health Act pathway, it’s therefore imperative that we carefully consider the way these forms are constructed. By consciously analysing the language and structure used, and considering how they might affect those from minority groups, we can begin to remove the unconscious bias from the current system. Simple changes which take into account extenuating contributors such as background, culture and stigma, can reduce the risk of bias and produce a more inclusive system of care.
To understand the extent of bias within the Mental Health Act, we must have a crystal clear idea of where it exists and what feeds it. By harnessing the powerful data provided by our digitisation of the act, it is possible to create such a picture. Digitisation not only offers us a larger pool of data than the paper-based system, but it is also more easily collated and compared. This makes it possible to identify geographical and demographic differences and highlight instances of bias and inequality.
From the demographic of overall admissions to treatment times and diagnoses among specific groups, data from the digital Mental Health Act can show us exactly where the problem of bias lies. And then, it can help us to solve it. Once we know exactly where bias is having an effect, we can start to analyse why and then put the necessary changes into action. Whether that’s rewording or redesigning a particular form, or adapting a specific process of admission or treatment, the improvements we make, when informed by reliable data, are more likely to succeed.
Research shows that black men are at a higher risk of experiencing a psychotic disorder than their white counterparts, and mental health disorders are more common among refugees and asylum seekers. For those from minority groups who face this increased risk of acute mental illness, and of being sectioned under the Mental Health Act, the swift delivery of treatment is vital. To help address the inequality, we must be ensuring that those who end up in acute mental health care are able to make as quick a recovery as possible.
Through digitisation, we’re making the mental health care pathway swifter, simpler and safer. Statutory forms can be completed, sent and accessed much more quickly. Action can then be taken immediately, allowing treatment to start sooner. The process is much simpler for practitioners to complete, reducing the time spent on administration, and freeing up time to be spent with the patients themselves.
Before all else, the Mental Health Act exists to safeguard those experiencing acute mental illness. It’s time we identify the holes in the net where bias is negatively affecting the experience of those from minority groups. In modernising the act we must commit to eradicating bias; building a stronger, safer system of care for all.
Arden spent 12 years working with private equity businesses helping them build best-in-class executive teams, manage company restructures, accelerate growth and prepare management buyout deals. Arden’s dad (also called Arden) is a psychiatrist, which opened his eyes to acute mental health care from a young age. After witnessing a close friend being sectioned first-hand, he founded Thalamos to improve the process and outcome for those in crisis.
Register here if you’d like to hear more about Thalamos courses, news and updates.