HIW: Some mental health patients in Wales coerced
A watchdog body has criticised the support offered to mental health patients in Wales, claiming some feel coerced into treatment.
Healthcare Inspectorate Wales (HIW) also found outdated consent forms, security breaches and patients not being made aware of their rights.
Mental health charity Mind Cymru said it had serious concerns that the needs of patients were not central.
The Welsh government said it would consider the report's findings.
In 2010-11, HIW spoke to 140 detained patients and examined the records of approximately 200.
Some told the inspectors they felt coerced into accepting treatment or staying in hospital informally after being told they would otherwise be detained under the Mental Health Act.
Staff were found to be in breach of the code of practice for not properly recording patients' notes and in several settings inspectors observed that important documentation could be detached from patient files.
In some cases the inspectorate found a number of consent-to-treatment certificates were over two years old.
During one unannounced visit an inspector was able to walk unchallenged on a locked ward having gained entry without having to show any proof of identification.
On the issue of Section 17 leave forms, which permits patients to stay overnight with family, the report said it was not clear whether family members had been consulted or any risk assessments undertaken.
Ruth Coombs, manager for influence and change at mental health charity Mind Cymru, said there were too many shortcomings.
"We have some serious concerns that patients are not being placed at the centre of care," she said.
"It would appear that they are not being provided with a safe therapeutic environment in which to get better, recover and then move on to go home.
"There is a lack of staff across the different professions in mental health, vacancy rates are higher than in other aspects of health care - it's very worrying to hear there is a lack of psychologists".
Ms Coombs welcomed an HIW warning that organisations which did not improve could be put into special measures.
"If putting an authority into special measures will actually support that organisation to make the changes that it needs to make, then that's something that needs to be considered and considered quickly," she said.
"It's very concerning that in the second year of reporting that the shortcomings found in the first year haven't been addressed and it does make us wonder if mental health is the priority that it is purported to be."
A Welsh government spokesperson said: "We welcome the HIW report and will now consider the detail, as well as any further work that is needed to ensure the (Mental Health) Act is being applied appropriately.
"Under the new Mental Health (Wales) Measure 2010, more service users will have access to independent mental health act advocates and increased involvement in care and treatment planning."