Detentions under the Mental Health Act

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1. Main facts and figures

  • people in the Black broad ethnic group were the most likely to have been detained under the Mental Health Act in 2016/17, and people in the White ethnic group were the least likely
  • among the specific ethnic groups, Black Caribbean people had the highest rate of detention of all ethnic groups for which ethnicity was reliably recorded
  • the highest rate of detention by far was for people recorded as being in the Any Other Black ethnic group, followed by those in the Any Other ethnic group – however, these are considered to be overestimates because ‘other’ categories may have been used by default where the specific ethnicity of a person was unknown
  • the actual rates of detention among people in the ethnic groups not labelled as ‘other’ – particularly those within the Black ethnic groups – may be underestimated
Things you need to know

Rates for people in the ‘other’ groups and in particular for those in the Other Black and Any Other ethnic group are thought to be over-estimated, and should be treated with caution. Rates of detention for specific ethnic groups, and particularly among Black ethnic groups, are likely to be under-estimated. This is because in many cases the detainee’s exact ethnicity wasn’t known. In such cases the ‘other’ ethnic categories may have been used as a default.

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. Because of this it is not possible to provide specific rates of detention for these groups.

The population figure for the White group includes the Gypsy or Irish Traveller population and the Other Ethnic Group includes the majority of the Arab population. While Arab detainees are sometimes recorded in another ethnic category, the extent to which they are contributing to the rates for the 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 2016/17. 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 – by 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 proportion 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. The potential causes of any differences cannot be identified or inferred from this analysis.

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 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 year 2016/17. Rates express the number of detentions under the Act in healthcare services that year per 100,000 people in each ethnic group.

These figures are for people who were detained for treatment or therapy by NHS-funded secondary mental health and learning disability and autism services only. They do not include detentions that take place within acute trusts, or 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.

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. Rates of detention (per 100,000) under the Mental Health Act 1983 by broad ethnic group

Location:
England
Time period:
2016/17
Source:
Mental Health Services Dataset
Number of detentions under the Mental Health Act per 100,000 people, by broad ethnic group (standardised rates)
Ethnicity Number per 100,000
Asian 82.1
Black 272.1
Mixed 157.0
White 67.0
Other 179.6

Download table data for ‘Rates of detention (per 100,000) under the Mental Health Act 1983 by broad ethnic group’ (CSV) Source data for ‘Rates of detention (per 100,000) under the Mental Health Act 1983 by broad ethnic group’ (CSV)

Summary of Detentions under the Mental Health Act Rates of detention (per 100,000) under the Mental Health Act 1983 by broad ethnic group Summary

  • people in the Black broad ethnic group were the most likely to have been detained under the Mental Health Act in 2016/17 – with 272.1 detentions per 100,000 Black people
  • the second highest rates of detention when looking at the broad ethnic groups were for people recorded as being in the Other ethnic group – however, these are considered to be overestimates because ‘other’ categories were often used by default where the specific ethnicity of a person was unknown
  • people in the White ethnic group had the lowest rate of detention, at 67.0 per 100,000 White people

3. Rates of detention (per 100,000) under the Mental Health Act 1983 by specific ethnic group

Location:
England
Time period:
2016/17
Source:
Mental Health Services Dataset
Number of detentions under the Mental Health Act per 100,000 people, by specific ethnic group (standardised rates)
Ethnicity Number per 100,000
Bangladeshi 107.6
Indian 53.2
Pakistani 97.4
Asian other 109.3
Black African 176.7
Black Caribbean 249.6
Black other 690.6
Mixed White/Asian 78.8
Mixed White/Black African 177.8
Mixed White/Black Caribbean 157.4
Mixed other 230.9
White British 64.3
White Irish 69.5
White other 132.8
Chinese 47.8
Any other 436.2

Download table data for ‘Rates of detention (per 100,000) under the Mental Health Act 1983 by specific ethnic group’ (CSV) Source data for ‘Rates of detention (per 100,000) under the Mental Health Act 1983 by specific ethnic group’ (CSV)

Summary of Detentions under the Mental Health Act Rates of detention (per 100,000) under the Mental Health Act 1983 by specific ethnic group Summary

  • Black Caribbean people had the highest rate of detention of all ethnic groups for which ethnicity was reliably recorded, at 249.6 detentions per 100,000 Black Caribbean people – this was significantly higher than for all other ethnic groups, not counting the Any Other Black and Any Other ethnic groups
  • the highest rates of detention by far were for people recorded as being in the Any Other Black and Any Other ethnic groups – however, these are considered to be overestimates because ‘other’ categories may have been used by default where the specific ethnicity of a person was unknown
  • the actual rates of detention among people in the ethnic groups not labelled as ‘other’ – particularly those within the Black ethnic groups – may be underestimated
  • the ethnic groups that were least likely to be detained (not counting those in the ‘other’ categories) were Chinese (47.8 per 100,000), Indian (53.2 per 100,000), White British (64.3 per 100,000) and White Irish (69.5 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. This provides information for people who used secondary mental health, learning disabilities and autism services.

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 are incomplete in 2016/17 due to changes introduced from that year to the way statistics were sourced and because not all providers of secondary mental health and learning disabilities services provided the data for all months in the year. As a result, the counts and rates shown are lower than the true figures. However, broad comparisons between ethnic groups are valid.

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 2016/17 was 64.3 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 63.5 and 65.1 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 in this range (ie between the upper and lower 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. To illustrate, there were fewer detentions for Caribbean people than for White British people, so we can be less certain about the estimate of 249.6 per 100,000 for the Caribbean group. This greater uncertainty is expressed by the wider confidence interval of between 236.6 to 262.6 per 100,000 Caribbean people.

Suppression rules and disclosure control

N/A N/A

Rounding

None

Related publications

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

Publication release date: 10 October 2017

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From: NHS Digital

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