National Preventive Mechanism Seventh Annual Report 2015–16 inspections, with the introduction of greater support to maintain family links, as well as positive outcomes found for many, although improvement in health care was needed. Medway Secure Training Centre In January 2016 the BBC broadcast a Panorama programme which depicted, in undercover footage, the abuse of children by staff at Medway STC. As a result the centre, which had been run by G4S, was put under the direct responsibility of the National Offender Management Service. Several staff members involved in the abuse and neglect were dismissed, and 12 were arrested. Criminal investigations are ongoing. NPM members carried out inspections shortly after the abuse came to light, not least because of concerns that previous inspections may not have picked up on the serious issues illustrated in the documentary. In these visits NPM monitors adopted a new approach to ensure all key issues were considered and all young people and staff were able to express their views. This new approach has since been reflected in revised methodologies for STC inspection. The case highlights the importance of continually refining inspection methodology and has been discussed in detail within the NPM. A number of failings were found during the re-inspection of Medway, and the government established an Improvement Board, following recommendations from NPM members, to monitor improvement and ensure recommendations are implemented. Health and social care detentions Detentions under the Mental Health Act (MHA) 1983 in England continued to rise for reasons that were unclear. During 2014–15 there were 58,399 detentions under the MHA, an increase of 5,223 (or 9.8%) compared with 2013–14 (53,176).8 This continued a trend of rising numbers of detentions in previous years. In the second half of 2014–15, 35% of the mental health inpatient population was detained under the MHA. Although the increasing number of detained patients has been a gradual change, it is a significant shift from the past patterns of use of compulsion in mental health law, with 5% of inpatients being detained in the 1970s and 8% on average by the mid-1990s.9 Reflecting patterns across the UK, in Scotland the number of episodes of detention under the Mental Health (Care and Treatment) (Scotland) Act continued to rise. In 2015–16 there were 2,193 episodes of emergency detention (which can last up to 72 hours), a rise of 9.3% on the previous year, and of 22.8% since 2011–12. There was a rise of 2.6% in short-term detention (up to 28 days) and the total number of new compulsory treatment orders (up to six months) rose by 8% to 1,366. In Wales the number of applications for deprivation of liberty safeguards saw a 16-fold increase on the previous year, from 631 applications in 2013–14, to 10,679 applications made between April 2014 and March 2015. This is partly due to the ongoing effects of an expansion of the legal definition of ‘deprivation of liberty’ in 2014. There was 8. Data from Health and Social Care Information Centre (2015) Inpatients formally detained in hospitals under the Mental Health Act 1983, and patients subject to supervised community treatment: Uses of the Mental Health Act: Annual Statistics, 2014/15, available at: http://content.digital.nhs.uk/catalogue/PUB18803/inp-det-m-h-a-1983-sup-com-eng-14-15-rep.pdf [accessed 01/11/16]. 9. On 31 December 1975, there were 146,718 patients resident in mental health and learning disability hospitals, of which 7,680 were detained under the MHA 1959. Review of the Mental Health Act 1959, Cmnd 7320, p.103. The 1990s data is taken from Hoggett, B (1996) Mental Health Law. Fourth Edition. London: Sweet & Maxwell, p.8. 14

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