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 is through the use of a short-term detention certificate.This route provides better safeguards for the patient than an emergency admission.
There has been no great change in the number of emergency and short-term detention certificates granted (table 2).
Rates continue to vary considerably between health boards. Excluding island areas (see notes - Tables 3 to 18)
- Rates of emergency and short-term detention are highest in Greater Glasgow and Clyde and Tayside.
- The rate of emergency detention in Dumfries and Galloway, previously very high, has fallen.
- If the overall ratio of emergency to short term detention is a reflection of the responsiveness of approved medical practitioners and mental health officers, Borders and Grampian have the most responsive services of all mainland NHS Boards and local authorities.
Emergency and short-term detention - sequences and pre-detention status.
The use of emergency and short-term detention is still higher for people already in hospital informally. We are visiting people detained in this way to find out the reasons for this. There has been no great change in this six-month period.
Consent
The law says that MHO consent for emergency detention should be obtained where practicable. 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.
Tables 59 and 60 shows variations between NHS board areas.Most areas are to be congratulated for achieving high rates of MHO consent. Ayrshire and Greater Glasgow and Clyde have consent rates below 50 %. The NHS Board and local authority partners should look into the reasons for this and take action to improve.
Mental Health Officers were recorded as not having given consent in 37% of emergency detention cases. In some other cases, it was not possible to identify the local authority that appointed the MHO. In these cases, the local authority is not given (see Table 51). There is considerable movement of MHOs between local authority areas, to provide out-of-hours services. For this reason, we have decided to publish figures for each are but not the rate per 100k of emergency detentions by area, or to attempt to compare areas.
Admissions of young people to non-specialist wards
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.
Services continue to report high numbers of young people being admitted to non-specialist facilities however we are seeing a drop in the under 16 admissions with the highest numbers, which have increased continuing to be in the 16-17 year-old group (figure 2).
When we looked at the type of ward that young people were admitted to (tables 54a and b), we found that the majority remain admissions to adult mental health wards. We had noted a shift previously to paediatric ward admissions but this does not appear to have been sustained.
Point prevelance information: number of people subject to compulsory powers on 6 October 2011
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 2011 census date, a total of 2903 people were subject to compulsion. Overall numbers changed little over the year.
Figure three shows that the number of people subject to CTOs at any one time has been stable over the last year. A third of all CTOs are community-based.
Gender and age patterns have changed little since the last report: 34% of people counted on the census date were women, 66% men (Table 56). Men are more likely to be subject to long term civil orders and to criminal procedure orders. Men subject to compulsory treatment tend to be younger (figures 4 and 5).
Tayside continues to have the highest rate of CTOs authorising detention in hospital. Highland now has the highest rate of community CTOs and is equal with Greater Glasgow and Clyde in having the highest overall rate of CTOs. Borders, Dumfries and Galloway and Lanarkshire have low rates of CTOs.
Adults with Incapacity Activity
Between April and September 2011, 857 welfare guardianship applications were notified to the Commission.As seen in previous trends reported quarterly, there were substantially more private welfare guardianships granted (626), than there were local authority ones (231).
In 73% 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 48%, significantly down from that recorded between April and September 2010 where the rate was 73%. 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.
A significant number of welfare guardianship orders are granted for people who may gain or recover some or all capacity or who may receive services at a future point which will enhance their capacity. The powers granted may not be necessary indefinitely. The trend to grant fewer indefinite guardianships appears to reflect this. We will continue to monitor this.
Social Circumstance 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). It should also 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. Furthermore, the MHO should write a covering letter to accompany the SCR to inform us of action we might need to take in respect of our statutory duties.
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 40% of STDCs trigger an SCR and 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. The table this year shows West Dunbartonshire, Highland, Scottish Borders, and Inverclyde all with very low compliance rates.
Detailed statistics
New compulsory treatment measures granted between 1 April and 30 September (Table 1 & 2)
New emergency orders, short-term orders and nurse holding powers granted by Health Board area, biannual data, 1 April - 30 September (Tables 3 to 18)
New emergency orders, short-term orders and nusre holding powers granted by MHO Local Authority, biannual data, 1 April - 30 September (Tables 19 to 52)
Emergency and short-term detention sequences and pre-detention status 1 April - 30 September 2011 (Table 53a and 53b)
Admissions of children and young people to adult psychiatric, general and paediatric wards for treatment (Table 54a and 54b)
Point prevelance data: numbers of people subject to compulsory powers on 5 October 2011 (Tables 55 to 58)
Emergency orders granted by health board area, with or without MHO consent, and by time granted, biannual data (Table 59 and 60)
Adults with Incapacity Act activity between 1 April and 20 September 2011 (Tables 61 to 65)
