The SKWAWKBOX reported this week on the shocking tripling of deaths – from 83 in 2011 to 252 in 2016 – among people detained under the Mental Health Act, as mental health and police services have been degraded under Tory government.
A further shocking phenomenon is revealed by the government’s Coroners’ Statistics: an increase of fifty-six percent in the number of deaths under ‘Deprivation of Liberty’ (DoL) authorisations.
The Mental Capacity Act (MCA) allows for organisations – hospitals, care homes and others – to apply for authorisation to deprive or restrict a person’s liberty on the grounds of their mental capacity if it is considered necessary for their safety. ‘Deprivation of Liberty Safeguards‘ (DoLS) exist to ensure – in theory – that a person is not unnecessarily deprived of any more of their liberty than is absolutely necessary for their safety. These only apply in England and Wales.
One of the key reasons for a DoL is dementia in its various forms. If a person can’t remember where they live, for example, a home would need to prevent them from leaving the facility unaccompanied or might need to restrict their access to the kitchen if they may forget to turn off an appliance.
DoL authorisations are also linked to the resources of the organisation applying for them. As a simple example, facility with enough people to provide one-to-one care around the clock would have less need to deprive an individual of liberty than one in which a staff member is looking after twenty residents or patients.
In 2015, the first year in which the figures were recorded, 7,183 people died while under DoL authorisations. In 2016, that number soared to 11,376.
In a small part, this is explained by an increase in the number of applications for DoL. But this only rose by 11%.
Another contributing factor will be the increasing total number of people deprived of their liberty. DoL should last only as long as required, but a person with dementia may be under an order for years.
In previous years – when DoL deaths were not reported – the number of applications has rocketed, for example a 900% increase in 2014/15. In the very early years after DoLS were launched in 2009, this might be attributed to increased awareness of the process – but five years later?
The inverse link between resources and the need for DoL applications would suggest that the annual increase in DoL applications is linked to starvation of resources among the organisations providing care.
The huge increase in deaths suggests that even DoL orders may be failing to safeguard vulnerable people. Of course, statistically some people will die in any group in any year.
But the steep rise in the both total and in the deaths per thousand people detained that the statistics reveal likely reflect the ongoing under-resourcing of social care, the continuing collapse of the NHS as funding slows – and the inability of organisations to cope on ever-tighter resources, even when using more and more often the extreme measure of depriving those in their care of liberty in at attempt to keep them safe.
The Tories’ plans to bring in the dementia tax were defeated by their failure in the General Election, but they are still extracting a toll from our elderly and vulnerable.
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