Detentions under the Mental Health Act

Published

1. Main facts and figures

  • among the 5 broad ethnic groups, people in the Black ethnic group were the most likely to have been detained under the Mental Health Act in 2017/18 (commonly known as being 'sectioned'), and people in the White ethnic group were the least likely to have been detained
  • among the specific ethnic groups, Black Caribbean people had the highest rate of detention out of all ethnic groups for which ethnicity was reliably recorded
  • the charts and tables show that the highest rate of detention was for people recorded as being in the Other Black ethnic group, followed by those in the Other ethnic group – however, these are considered to be overestimates because ‘other’ categories may have been used for people whose specific ethnicity wasn’t known
  • similarly, the actual rates of detention among people in the ethnic groups not labelled as ‘other’ may be underestimated – particularly those within the Black ethnic groups
  • overall, it is estimated that detentions increased by 2.4% between 2016/17 and 2017/18 – this is based on figures from service providers who submitted good quality data in each of the last 3 years, rather than all providers
Things you need to know

Rates for people in the 5 ‘other’ ethnic groups (Other Asian, Other Black, Other Mixed, Other White, and Any Other) are thought to be overestimated, and should be treated with caution. This is particularly the case for those in the Other Black and Any Other ethnic group. This is because ‘other’ categories may have been used for people whose specific ethnicity wasn’t known.

As a result, rates of detention for specific ethnic groups that aren’t ‘other’ categories are likely to be underestimated, particularly among Black ethnic groups.

The Gypsy and Traveller of Irish Heritage, and Arab ethnic groups are not separately identified in the data submissions from NHS providers of mental health and learning disability services. As a result, it is not possible to provide specific rates of detention for these groups.

The population figure for the White group includes people from the Gypsy or Irish Traveller ethnic group. The population figure for the ‘Any Other’ ethnic group includes the majority of the Arab population. Detainees from the Arab ethnic group are sometimes recorded in another ethnic category, but the extent to which they are contributing to the rates for the Any Other ethnic group is unknown.

The rates for all ethnic groups are likely to be further underestimated because not all providers of secondary mental health and learning disabilities services provided the data for all months in either year and some providers did not submit any data at all.

Although this means the numbers of detentions and rates shown are lower than the true figures, it is still possible to make broad comparisons between groups.

These estimates have been adjusted to allow the rates of detention to be compared between ethnic groups as if they had the same age profile (known as ‘age-sex standardisation’). This is helpful as ethnic groups can have very different age profiles (that is the number of people of different ages, which can further differ between men and women) and because the prevalence of mental health disorders is also related to people’s age and sex.

As a result, the estimates do not tell you the actual percentage of people in each ethnic group who were detained. To allow for this adjustment to be made, the analysis is limited to detentions where the person’s gender, age and ethnicity was recorded.

No adjustment has been made to these figures to account for differences in need or severity of mental health symptoms between different ethnic groups. As such any differences shown may be related to differences in need, availability of services, or other related factors. This analysis does not identify or help determine the potential causes of any differences observed.

As with any data source, errors may have been made when collecting, preparing or interpreting the data. The greater the number of people included for each ethnic group, the more reliable the value for that group. Data is collected on a smaller number of detainees from ethnic minority groups than from the White British ethnic group. Therefore figures for ethnic minorities (including White minorities) are less reliable than the figures presented for White British people.

What the data measures

The data measures rates of detention among people of all ages under the Mental Health Act 1983 for different ethnic groups in England in financial years 2016/17 and 2017/18.

Rates express the number of detentions under the Act in healthcare services per 100,000 people in the general population in each ethnic group.

These figures are for people who were detained in hospital for assessment or treatment under the Mental Health Act. They do not include detentions under Section 136 that take place in non-healthcare settings (for example in police cells).

The Mental Health Act 1983 covers the assessment, treatment and rights of people with a mental health disorder. It provides the legislation under which people who need urgent treatment for a mental health disorder (and are at risk of harm to themselves or others) can be detained. This is commonly known as ‘being sectioned’.

People were included in the statistics if they were detained:

  • under Part II of the Act
  • under Part III of the Act
  • under previous legislation (Fifth Schedule) and other Acts
  • having already been admitted to hospital
  • after a Place of Safety order has been used
  • after a Community Treatment Order has been revoked
The ethnic categories used in this data

The 16 categories used in this data are those listed in the 2001 Census, which are still used in the NHS in England.

White:

  • English/Welsh/Scottish/Northern Irish/British
  • Irish
  • Any Other White background

Mixed/Multiple ethnic groups:

  • White and Black Caribbean
  • White and Black African
  • White and Asian
  • Any Other Mixed/Multiple ethnic background

Asian/Asian British:

  • Indian
  • Pakistani
  • Bangladeshi
  • Any Other Asian background

Black/African/Caribbean/Black British:

  • African
  • Caribbean
  • Any Other Black/ African/ Caribbean background

Other ethnic group:

  • Chinese
  • Any Other ethnic group

2. By ethnicity (5 ethnic groups)

Number of detentions under the Mental Health Act per 100,000 people, by broad ethnic group (standardised rates)
Ethnicity 2016/17 2017/18
Number per 100,000 Number per 100,000
Asian 82.1 91.9
Black 272.1 288.7
Mixed 157.0 158.4
White 67.0 71.8
Other 179.6 180.3

Download table data (CSV) Source data (CSV)

Summary

This data shows that:

  • among the 5 broad ethnic groups, people in the Black ethnic group were the most likely to have been detained under the Mental Health Act in 2017/18, at a rate of 288.7 detentions per 100,000 Black people
  • the second highest rate of detention was among people in the Other ethnic group, at 180.3 detentions per 100,000 people from this ethnic group – however, this is considered to be an overestimate because ‘other’ categories may have been used for people whose specific ethnicity wasn’t known
  • people in the White ethnic group had the lowest rate of detention, at 71.8 detentions per 100,000 White people
  • overall, it is estimated that detentions increased by 2.4% between 2016/17 and 2017/18 – this is based on figures from service providers who submitted good quality data in each of the last 3 years, rather than all providers

3. By ethnicity (16 ethnic groups)

Number of detentions under the Mental Health Act per 100,000 people, by specific ethnic group (standardised rates)
Ethnicity 2016/17 2017/18
Number per 100,000 Number per 100,000
Asian
Bangladeshi 107.6 129.7
Indian 53.2 55.7
Pakistani 97.4 112.6
Asian other 109.3 124.5
Black
Black African 176.7 205.6
Black Caribbean 249.6 254.3
Black other 690.6 745.9
Mixed
Mixed White/Asian 78.8 77.6
Mixed White/Black African 177.8 193.5
Mixed White/Black Caribbean 157.4 149.3
Mixed other 230.9 236.4
White
White British 64.3 69.0
White Irish 69.5 74.7
White other 132.8 138.9
Other inc Chinese
Chinese 47.8 46.3
Any other 436.2 432.9

Download table data (CSV) Source data (CSV)

Summary

This data shows that:

  • among the 16 specific ethnic groups, Black Caribbean people had the highest rate of detention of all ethnic groups for which ethnicity was reliably recorded, at 254.3 detentions per 100,000 Black Caribbean people in 2017/18
  • the highest rates of detention by far were for people recorded as being in the Other Black and Any Other ethnic groups – however, these are considered to be overestimates because ‘other’ categories may have been used for people whose specific ethnicity wasn’t known
  • the actual rates of detention among people in the ethnic groups not labelled as ‘other’ may be underestimated, particularly those within the Black ethnic groups
  • the ethnic groups with the lowest detention rates (not counting the ‘other’ categories) were Chinese (46.3 detentions per 100,000 people), Indian (55.7 per 100,000), White British (69.0 per 100,000) and White Irish (74.7 per 100,000)

4. Methodology

This analysis uses data collected through monthly submissions made using version 1.1 of the Mental Health Services Dataset (MHSDS) during the financial year 2016/17 and version 2 of MHSDS during the financial year 2017/18. This provides information for people who were detained under the Mental Health Act.

The analysis also uses Census 2011 population data for each ethnic group. In a small number of cases, a person did not have their ethnicity recorded in the dataset. This means that the ethnicity totals may not add up to the national totals.

Detentions data was incomplete in 2016/17 because not all providers of secondary mental health and learning disabilities services provided the data for all months in the year and some providers did not submit any data at all. As a result, the counts and rates shown are lower than the true figures. However, broad comparisons between ethnic groups for a given year are valid.

In 2017/18, the methodology remained the same but improved data quality means that the actual increase in detentions is likely to be less than that reported. Trend comparisons are also affected by improving data quality. Based on the providers who submitted good quality detentions data in each of the last 3 years, we estimate there was an increase in detentions of 2.4 per cent between 2016/17 and 2017/18. Broad comparisons between ethnic groups for a given year are still valid however.

Although Gypsy and Arab are identified in the population figures in the download, these groups are not separately identified in the MHSDS, so separate rates are not available for these groups. People from an Arab background do not always identify with the same broad ethnic category (they may, for example, identify as Asian or Any Other ethnic group). The way this affects the rates shown is unknown.

The broad ethnic groups used for rates of detention by broad ethnic group follow the 2001 Census groupings, which are still used in the NHS. However the 2011 census re-positions 'Chinese' from Any Other ethnic group to Asian/Asian British. This means that figures using 2011 Census categories will not be comparable with any using 2001 Census categories for 'Any Other' and 'Asian’.

Confidence intervals:

The confidence intervals for the estimate of the standardised rates per 100,000 population for each ethnic group are available in the download the data section.

The number of detentions for White British people under the Mental Health Act in 2017/18 was 69.0 per 100,000 population. This is a reliable estimate based on the people detained that year, but it is not possible to be 100% certain of the true rate of detention for this population.

It’s 95% certain, however, that the rate of detention lies somewhere between 68.2 and 69.8 per 100,000 White British people. In statistical terms, this is a 95% confidence interval. This means that 95 times out of 100 the estimate would fall between the upper and lower bounds of the confidence interval. But 5 times out of 100 it would fall outside this range. The lower confidence interval is calculated by subtracting the confidence interval estimate of 0.8 from the estimate of the standardised rate of detentions. The upper confidence interval rate is calculated by adding 0.8 to the estimate.

The smaller the number of detentions, the more uncertain the estimate and the wider the confidence interval. For example, there were fewer detentions for Caribbean people than for White British people, so we can be less certain about the estimate of 254.3 per 100,000 for the Black Caribbean group. This greater uncertainty is expressed by the wider confidence interval of between 241.2 to 267.4 per 100,000 Black Caribbean people.

Related publications

Mental Health Act Statistics, Annual Figures: 2016-17, Experimental statistics

Mental Health Act Statistics, Annual Figures: 2017-18, National Statistics

5. Data sources

Source

Type of data

Administrative data

Type of statistic

Experimental statistics

Publisher

NHS Digital

Publication frequency

Yearly

Purpose of data source

The Mental Health Services Dataset (MHSDS) collects data from providers of NHS-funded secondary mental health, learning disability and autism services in England. It is a mandatory monthly return of data generated in the course of providing services to patients.

6. Download the data

Detentions_under_the_mental_health_act - Spreadsheet (csv) 2 KB

This file contains the following: ethnicity, year, crude rate, standardised rate, denominator, numerator, confidence interval