Detentions under the Mental Health Act

Published

1. Main facts and figures

  • in the year to March 2019, Black people were more than 4 times as likely as White people to be detained under the Mental Health Act – 306.8 detentions per 100,000 people, compared with 72.9 per 100,000 people

  • out of the 16 specific ethnic groups, Black Caribbean people had the highest rate of detention out of all ethnic groups (excluding groups labelled ‘Other’)

  • the highest rate of detention was for people in the Black Other ethnic group, followed by those in the Mixed Other ethnic group – however, these rates 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 for 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 2.0% in the year to March 2019 – this is based on figures from service providers who submitted good quality data in each of the last 4 years, rather than all providers

Things you need to know

Rates for people in the 5 ‘Other’ ethnic groups are thought to be overestimated, and should be treated with caution. This includes:

  • Other Asian
  • Other Black
  • Other Mixed
  • Other White
  • Any Other

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 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 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’). Ethnic groups can have very different age profiles. The number of people of different ages can differ between men and women. The likelihood of mental health disorders is also related to people’s age and sex.

As a result, the estimates do not show 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.

Errors may have been made when collecting, preparing or interpreting the data. The larger 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. This means figures for ethnic minorities, including White minorities, are less reliable than the figures for White British people.

What the data measures

The data measures rates of detention for people of all ages under the Mental Health Act 1983. Rates are shown for different ethnic groups in England in the financial years 2017 to 2018 and 2018 to 2019.

The rates show 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 Act. They do not include detentions under Section 136 that take place in non-healthcare settings, for example 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 who 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 2 of the Act
  • under Part 3 of the Act
  • under previous legislation (Fifth Schedule) and other Acts
  • having already been admitted to hospital
  • after a Place of Safety order had been used
  • after a Community Treatment Order was 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.

2. By ethnicity (5 ethnic groups)

Number of detentions under the Mental Health Act per 100,000 people, by aggregated ethnic group (standardised rates)
Ethnicity 2017/18 2018/19
Number per 100,000 Number per 100,000
Asian 91.9 103.4
Black 288.7 306.8
Mixed 158.4 232.8
White 71.8 72.9
Other 180.3 173.4

Download table data for ‘By ethnicity (5 ethnic groups)’ (CSV) Source data for ‘By ethnicity (5 ethnic groups)’ (CSV)

Summary of Detentions under the Mental Health Act By ethnicity (5 ethnic groups) Summary

The data shows that:

  • Black people were most likely to be detained under the Mental Health Act in the year to March 2019, with 306.8 detentions per 100,000 people

  • the next highest rate of detention was for people in the Mixed ethnic group – 232.8 detentions per 100,000 people

  • White people had the lowest rate of detention – 72.9 detentions per 100,000 people

  • overall, it’s estimated that detentions increased by 2.0% in the year to March 2019 – this is based on figures from service providers who submitted good quality data in each of the last 4 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 2017/18 2018/19
Number per 100,000 Number per 100,000
Asian
Bangladeshi 129.7 141.7
Indian 55.7 70.9
Pakistani 112.6 117.6
Asian other 124.5 134.0
Black
Black African 205.6 221.6
Black Caribbean 254.3 276.5
Black other 745.9 728.1
Mixed
Mixed White/Asian 77.6 82.3
Mixed White/Black African 193.5 188.2
Mixed White/Black Caribbean 149.3 177.6
Mixed other 236.4 474.2
White
White British 69.0 70.1
White Irish 74.7 74.8
White other 138.9 141.2
Other including Chinese
Chinese 46.3 52.2
Any other 432.9 410.8

Download table data for ‘By ethnicity (16 ethnic groups)’ (CSV) Source data for ‘By ethnicity (16 ethnic groups)’ (CSV)

Summary of Detentions under the Mental Health Act By ethnicity (16 ethnic groups) Summary

The data shows that:

  • Black Caribbean people had the highest rate of detention out of all ethnic groups (excluding groups labelled ‘Other’), with 276.5 detentions per 100,000 people in the year ending March 2019

  • the highest rates of detention were for the Other Black, Other Mixed 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 for 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 (52.2 detentions per 100,000 people), White British (70.1 per 100,000), Indian (70.9 per 100,000) and White Irish (74.8 per 100,000)

4. Methodology

The analysis uses data collected through monthly submissions made using the Mental Health Services Dataset (MHSDS). It uses data from:

  • version 2 of the MHSDS during the 2017 to 2018 financial year

  • version 3.0 of MHSDS during the 2018 to 2019 financial year

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 from 2017 to 2018. This is because not all providers of secondary mental health and learning disabilities services provided 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.

From 2018 to 2019, the methodology remained the same, however 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% in the 2 years to March 2019. Broad comparisons between ethnic groups for a given year are still valid.

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

The ethnic groups used for rates of detention by aggregated ethnic group follow the 2001 Census groupings, which are still used in the NHS. However, the 2011 census moved 'Chinese' from the ‘Any Other’ ethnic group to ‘Asian/Asian British’. This means that figures using 2011 Census categories can’t be compared 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 from 2018 to 2019 was 70.1 per 100,000 people. This is a reliable estimate, however it’s not possible to be 100% certain of the true rate of detention for this population.

It is 95% certain that the rate of detention is somewhere between 69.3 and 70.9 per 100,000 White British people. In statistical terms, this is a 95% confidence interval. This means 95 times out of 100 the estimate would fall between this range, and 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 276.5 per 100,000 for the Black Caribbean group. This greater uncertainty is expressed by the wider confidence interval of between 262.8 to 290.2 per 100,000 Black Caribbean people.

Related publications

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

Mental Health Act Statistics, Annual Figures: 2018-19, National Statistics

Quality and methodology information

5. Data sources

Source

Type of data

Administrative data

Type of statistic

Official statistics

Publisher

NHS Digital

Publication frequency

Monthly

Purpose of data source

The Mental Health Services Data Set (MHSDS) has information about people who are in contact with mental health, learning disabilities and autism services. It uses clinical and operational data for purposes other than direct patient care.

6. Download the data

Detentions under the Mental Health Act - Spreadsheet (csv) 4 KB

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