“I’m not getting out.” An exploration into people’s lived experience of hearings to review detention under the Mental Health Act

This thesis focuses on the lived experience of what it is like to be an inpatient detained under the Mental Health Act (MHA) in England and Wales. It aims to evaluate and contribute to national efforts being made to improve the experience of people under the care of the National Health Service (NHS); specifically in this case detained inpatients.

Paper 1 presents a review of the existing literature about the general lived experience of being detained as an inpatient under the MHA. It was found that people overall had a negative experience of detention. Significant aspects of this experience included the importance of being included, validated and treated with respect and the restrictions imposed on them whilst detained. This review indicated ways that experiences of detention could be improved, and further research that could be done to explore this.

Paper 2 is an empirical paper addressing the research question of what it is like to attend a hearing to review detention under the MHA after which detention is upheld. Thematic analysis was used to analyse data from interviews with eight participants. Three themes were identified: ‘Getting out’ (sub-themes: ‘Understanding vs Expectations’ and ‘Left To It’), ‘F**k…I’m not getting out’ (sub-theme: ‘Silenced’) and ‘I’m stuck here’ (sub-themes: ‘Captive’ and ‘I shouldn’t even be here’). Clinical implications are discussed with recommendations for future research.

An executive summary of this research is presented in Paper 3. It provides evidence about how detention review hearings resulting in upheld detention are experienced by inpatients, and suggestions on how this may be improved. This can be used to support health and social care initiatives aiming to improve mental health service-users’ experience.