The SARS-Cov-2 pandemic has produced challenges for mental health services, but it also provides opportunities to reassess and improve our mental health care system. When National Health Service England (NHSE) asked service providers to free up inpatient capacity1, many, particularly in London, discharged large numbers with informal reports of up to a fifth of people who were previously detained being discharged. In Lombardy and Madrid mental health beds were closed and wards converted for Covid-19 patients, but clinical colleagues tell us that this was not achieved by discharging people who had been legally detained. If we understand how this discharge rate was achieved, and why it was different to other services in Europe then we might be able to improve services in the future. There have been no changes to the detention criteria that could justify why people who pre-covid warranted formal detention, now no longer warranting that detention now the pandemic is upon us. These discharge rates raise questions about whether the threshold for detention was adequately stewarded pre-covid-19. Perhaps we have been depriving people with mental health difficulties of their liberty unjustly?

 

Woman suffering an anxiety attack alone in the night

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