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Half yearly statistics

 (To view tables and figures, please use the links provided at the bottom of this page)

Emergency and short-term detention

The Code of Practice, which supports good practice under the Act, makes it clear that the preferred route for a person into compulsory treatment isthrough the use of a short-term detention certificate.This route provides better safeguards for the patient than an emergency admission.

In this period, there were 63 people recalled to hospital because of non-compliance with measures in a community CTO. A further 39 people were admitted from community orders under either emergency or short-term provisions because they had become unwell. These numbers are higher than we expected. In our overview report for the whole of 2009-10, we found 89 and 68 respectively. We are seeing around 50% more people recalled because of non-compliance than we expected.

There has been no great change in the number of emergency and short-term detention certificates granted (table 2). The number of women under 45 detained under a short-term detention certificate is slightly higher than expected. We will look to see if this is significant when we produce our annual monitoring report.

Rates continue to vary considerably between health boards. Excluding island areas (see notes), Emergency detention rates are particularly low in Borders and Grampian. The rate remains highest in Dumfries and Galloway and appears even higher than last year.Borders and Lanarkshire have relatively low rates of short-term detention. The rate is still highest in Greater Glasgow and Clyde.

For Scotland as a whole, 63% of all emergency detention certificates (EDCs) granted in the six month period had the consent of a mental health officer (MHO). Overall, 37% of EDCs in Scotland did not have MHO consent.

Fife and Borders had very high rates of MHO consent. In Ayrshire and Arran, most emergency detentions did not have MHO consent. This was particularly evident for out-of hours emergency detention.

Emergency and short-term detention - sequences and pre-detention status.

Our data shows that the single commonest type of episode is the episode of short-term detention only. Just over a quarter of all episodes involve a full compulsory treatment order (CTO). The great majority of episodes of compulsory treatment never become "full" CTOs.

Almost half of all people who are treated under a CTO without first being detained under emergency or short-term detention certificates are treated in the community

Community-based compulsory treatment orders (CCTOs)

Table one shows that there were 63 people recalled to hospital because of non-compliance with measures in a community CTO. A further 39 people were admitted from community orders under either emergency or short-term provisions because they had become unwell. These numbers are higher than we expected. In our overview report for the whole of 2009-10, we found 89 and 68 respectively. We are seeing around 50% more people recalled because of non-compliance than we expected.

Young People - admissions to non-specialist facilities

We continue to monitor admissions of children and young people to non-specialist facilities on a quarterly basis. This reflects the importance we place on this area and the need to monitor it closely. Also, "Delivering for Mental Health" made a commitment to reducing this type of admission.

Services continue to report high numbers of young people being admitted to non-specialist facilities and there is no sign of progress towards significant reductions. The number is highest in the 16-17 year-old group (figure 2).

When we looked at the type of ward that young people were admitted to (tables 54 a and b), we found a shift away from adult mental health ward towards paediatric wards in this quarter. It will be interesting to see if this was a "one-off" finding or if it is repeated in future quarters.

Point prevalence information: numbers of people subject to compulsory powers on the 6th October 2010

At the start of every quarter we use our database to conduct a census of people subject to compulsory powers on the selected date. We use this to pay particular attention to long-term orders, e.g. compulsory treatment orders and compulsion order, with or without restriction orders.

Table 55 shows all the people subject to compulsory treatment at census dates over the last four quarters. On the October 2010 census date, a total of 2757 people were subject to compulsion, slightly lower than the previous three quarters.

Figure three shows a slight overall fall in the number of people subject to CTOs, especially those order that authorise detention in hospital. The total number of people on community CTOs at any one time has remained stable and makes up about a third of all CTOs.

Gender and age patterns have changed little since the last report: 36% of people counted on the census date were women, 64% men (Table 56). Men are more likely to be subject to long term civil orders and to criminal procedure orders. Figures four and five show that it is younger men and older women that are more likely to be treated under the act.

Tayside has the highest rate of CTOs authorising detention in hospital. Greater Glasgow and Clyde has the highest use of community CTOs. Lanarkshire has a remarkably low use of both types of CTO (table 57)

Adults with Incapacity Act activity

Between April and September 2010, 700 welfare guardianship applications were notified to the Commission.As seen in previous trends reported quarterly, there were substantially more private welfare guardianships granted (495), than there were local authority ones,(205).

In 71% of applications notified, the applicant was a relative or carer. (percentage includes a very small number of other miscellaneous, non local authority guardianships).

We use primary diagnosis to report on causes of incapacity. Table 63 shows that the most common cause of incapacity in younger age groups is learning disability. In older age groups the main cause of incapacity is dementia.

The proportion of orders granted for an indefinite duration for this six month period, stands at 73%, (Table 64). We have reported our concerns about indefinite welfare guardianship as there is no automatic judicial review. A significant number of welfare guardianship orders are granted for people with acquired brain injury and alcohol-related brain damage. These conditions can improve and the powers may not be necessary indefinitely.

In 99% of orders granted, the power to determine care and accommodation (or where adult should reside) was included.(Table 65)

Social Circumstances Reports by Local Authority

The code of practice states that the purpose of an SCR is first of all to provide the RMO with information which may assist in the assessment of the patient (including an assessment of potential risks) and identify, at an early point, aspects of health and welfare, as well as any support needs of carers, which the MHO feels should be addressed in developing the care and treatment plans either on a formal or an informal basis. The SCR should also inform us of the patient's wider circumstances prior to their being subject to compulsory powers and whether any alternative courses of action might have been or are being considered and what these courses of action are. If the MHO considers that an SCR would serve little or no practical purpose, we must be notified of this. We think that there are too many "relevant events" that trigger an SCR but the granting of a short-term detention certificate (STDC) is an important one.

We still find that only 41% of STDCs trigger an SCR are we have neither an SCR nor a notification of why one was not provided in half of all STDCs. Local authorities appear not to be complying with this part of the Act in many cases. City of Edinburgh and Highland have lowest rates of compliance.

Detailed statistics