Councils struggling with the rise in costs of assessing when mental health patients can be detained

  • Councils are struggling to cope with a tenfold increase in assessment of mental health patients when hospitals or care homes wish to deprive them of their liberty. /images/mentalhealth.jpg

    In March a court ruling increased the number of patients protected under the Mental Capacity Act deprivation of liberty safeguards (DoLS), and since then assessments have soared from just over 10,000 last year, to 94,000 this year according to the Association of Directors of Social Services.

    Since 2009, if a hospital or care home wants to deprive a patient of their liberty - by limiting where they can go, or what they can do - it must get any such restrictions approved by the local authority, reports the Guardian.

    Since a court ruling in March 2014 safeguards must now be followed whenever a patient is being deprived of their liberty, regardless of how comfortable or contented they appear to be with their lot. "A gilded cage is still a cage," the supreme court ruled.

    David Pearson, the president of Adass, agrees this level of scrutiny is needed in order to protect patients he describes as "the most vulnerable of the most vulnerable", but says additional staffing and legal costs generated by the increase in DoLS applications is putting already hard-pressed council budgets under strain. "There will have to be further cuts to pay for the cost of this additional work," he says. With a large proportion of DoLS assessments comprising og older people with dementia, costs are set to rise further as the population ages.

    Many local authorities say they have been caught out by the scale of change imposed by the supreme court. "We had no time to prepare for it," says Andrew Webb, director of services for people at Stockport council. "It has put us under huge pressure." Webb estimates that dealing with the extra DoLS applications could add £700,000-£1.1m to Stockport's  social work budget.

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