Mental impairment in the West Midlands: 10 years on.

In 1989, a survey was undertaken to describe the learning disabled population, originating from the West Midlands, classified as mentally impaired or severely mentally impaired under the Mental Health Act 1983. The results obtained were then used to help guide future service development within the region. Given the marked changes in service provision over the subsequent decade, the study was repeated in 1998-1999, looking at the same population on 1st December 1997 (prior to the Bournewood Ruling). Attempts were made to identify all people residing within the West Midlands region, or originating from it, and classified as mentally impaired or severely mentally impaired under the Mental Health Act (1983). This was achieved by contacting medical records departments, learning disability consultants and Health Authorities. The same data set as the original study was then collected from case notes to allow comparison. The current study however, collected extra information, relating to diagnosis, treatment and outcome. Ninety-three people were identified for the study. Over the 10 years, there has been approximately a 100% increase in the numbers of people detained under these categories of the Mental Health Act (1983). There has been a marked increase in the use of the private sector, as well as out-of-region placements. Sexual offending seemed a common reason for detention. The authors attempt to explain this phenomenon. They also highlight the need for future developments and greater systematic data collection.