Rising rates of involuntary detention: is there a solution?

Date: Thursday 20 June
Time: 10.30am - 11.45am
Stream: Quality improvement


Rates of involuntary detention have been rising in a number of different countries. The UNCRPD has questioned the use of detention in those with disabilities. Some groups have campaigned for involuntary detention to stop altogether but there are considerable risks to this approach. Others have argued for the threshold for detention to be increased and the use of detention to be restricted. In the five decades since the 1980s, deinstitutionalisation has occurred, and services have been transformed. Paradoxically there has been a massive increase in rates of detention at the same time. Dr Shubulade Smith will chair this session. She has expertise in this area from clinical and academic work. As President of the Royal College of Psychiatrists she brings the perspective from the UK, where there is considerable variation in approach between each of the home nations, and the international perspective. Dr Smith will co-chair the session alongside an expert by experience of involuntary detention.  Dr Patrick Keown will describe these changes including changes in rates of detentions, court orders and prison transfers, along with other changes in mental health and learning disability services in England. Professor Claire Henderson will present evidence that Advance Choice Documents can reduce rates of involuntary detention and can address the racial disparities that are evident amongst those detained in hospital. Professor Kam Bhui will present learning from experience-based co-design to facilitate system-wide changes and enable the voices of service users at risk of detention to radically reform policy. The session will consider what can be done to address the concern about the significant increase in the rate of involuntary detention. It will consider ways that rates of detention can be reduced, and what the consequences of reducing rates of involuntary detention are likely to be and ways to mitigate these risks.


This session aims to:

  • Knowledge of changes in rates of involuntary detentions
  • Understand the evidence to practice gap in relation to Advance Choice Documents (ACD)
  • Consider how barriers to ACD implementation can be addressed in your workplace
  • Awareness of experience-based co-design to facilitate system wide change


Chair: Dr Lade Smith CBE, President, Royal College of Psychiatrists, London

Dr Patrick Keown, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle

Professor Claire Henderson, King's College London, London

Professor Kam Bhui, University of Oxford, Oxford

Please email congress@rcpsych.ac.uk or call 020 8618 4120 with any enquiries.