An audit of the quality of reports to Mental Health Review Tribunals

Abstract

The Mental Health Review Tribunal (MHRT) Rules 1983 place a statutory responsibility on the Responsible Authority to provide the tribunal with a formal medical report. Such reports are valuable records providing a systemic and evidence-based viewpoint for detaining an individual under the Mental Health Act 1983 (MHA). The reports allow the treating team to present its concerns and subsequent care package to the tribunal, whose members could be from a non-mental health background. There is evidence that the majority of the MHRT reports do not satisfactorily meet the tribunal's requirements. Recent literature has indicated that the circulation of structured guidelines has resulted in improved quality of the reports. The authors undertook an audit cycle to test the above hypothesis. A preliminary audit ascertained the current practice of MHRT report-making in Cornwall. The reports were objectively assessed against 'gold standards' of a comparative framework of eighteen criteria laid out by the Royal College of Psychiatrists. The guidelines were circulated in the form of a template and a re-audit carried out to ascertain any change in practice. The subsequent re-audit demonstrated significant improvements in the quality of reports.