Leave for informally admitted patients: a review of written guidance produced by mental health services in England and Wales

Abstract

PurposeThe purpose of this paper is to report on the use and content of written guidance produced by mental health services in England and Wales describing hospital leave for informally admitted patients.Design/methodology/approachGuidance on leave was requested from National Health Service (NHS) mental health trusts in England and health boards in Wales (n = 61) using a Freedom of Information submission. Data were analysed using content analysis.FindingsIn total, 32 organisations had a leave policy for informal patients. Policies varied considerably in content and quality. The content of policies was not supported by research evidence. Organisations appeared to have developed their policies by either adapting or copying the guidance on section 17 leave outlined in the Mental Health Act Codes of Practice for England and Wales (Department of Health, 2016; Welsh Government, 2016). Definitions of important terms, for example, leave and hospital premises, were either absent or poorly defined. Finally, some organisations appeared to be operating pseudo-legal coercive contracts to prevent informal patients from leaving hospital wards.Research limitations/implicationsResearch should be undertaken to explore the impact of local policies on the informal patient’s right to life and liberty.Practical implicationsAll NHS organisations need to develop an evidence-based policy to facilitate the informal patient’s right to take leave. A set of national standards that organisations are required to comply with would help to standardise the content of leave policies.Originality/valueTo the best of the author’s knowledge, this is the first study to examine the use and content of local policies describing how informal patients can take leave from hospital.