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The Care Quality Commission (CQC) has published its most recent annual report monitoring how the Mental Health Act 1983 (MHA) is applied in England during 2024/25. The report examines the experiences of people detained under the Act as well as how services registered to assess, treat and care for them are performing.
At its core, the MHA is the legal framework that allows hospitals and services to detain and treat individuals with mental illness when there is a risk to their own health or safety, or to others. It also includes powers for community treatment orders and guardianship.
CQC carried out detailed regulatory activity across hundreds of services, speaking directly with patients, carers and staff as part of the monitoring process. Some of the key themes highlighted in the report include:
Long waits and rising acuity
The findings suggest that many people are becoming more unwell before being assessed under the MHA because of delays in accessing mental health care. Services are reporting increased demand and longer waiting times for assessment, meaning people are often admitted when their condition has already deteriorated.
Use of community treatment orders growing
Between 2023/24 and 2024/25, there was an observed rise in the use of community treatment orders. These are legal tools that allow people to receive treatment while living in the community but remain subject to certain conditions under the Act.
The report sits against a backdrop of broader mental health system challenges, including workforce shortages and inconsistent service provision. Independent analysis of the report has noted persistent constraints on staff capacity and inequities in access, with people in more deprived areas or from ethnic minority backgrounds disproportionately affected. Advocacy groups have criticised the normalisation of unsafe care environments and the ongoing shortfall in resources.
This annual report is an important snapshot of how the Mental Health Act is functioning in practice, offering insights into where mental health services are under strain and where improvements are most needed. It provides evidence for policymakers, providers and campaigners seeking to shape how care is delivered and regulated in the years ahead.
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