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Compulsory treatment and the over-65s

  

Compulsory orders for people aged 65 and over, 2007- 2010

 AR-09-10-Table27

 

Compulsory orders for people aged 65 and over, 2007-10

 

Fig-27a

*EDC - emergency detention certificate, STDC - short term detention certificate
 CTO - compulsory treatment order.

 

Our interest in this

Two years ago we identified that there was a big rise in the use of the Mental Health (Care& Treatment) (Scotland) Act 2003 for people aged 85 and over. This year, we found that all orders for people age 65 and over had risen substantially. We wanted to look into this more.

What we found

The table and figure above demonstrate the rise in the use of all three main civil orders for people aged 65 and over. We do not think that the over 65 population of Scotland has grown enough to explain this. We looked into the diagnoses of people whose detention progressed to a community treatment order (CTO).

We found data on all but one of the 303 people aged 65 and over who were subject to a CTO. We also found data on all 254 people who were made subject to a CTO last year.  We looked at whether orders were being used for people with dementia, people with "functional" mental illness (e.g. depression, bipolar disorder or paranoid illnesses) people with alcohol-related brain damage (ARBD), or other diagnoses. 

In the population aged 65 and over, CTOs are used most often for people with dementia. We have looked into the circumstances of these orders before and believe that the 2003 Act is being used appropriately.

We have had concerns that people with dementia who may not be consenting to their care and treatment were being deprived of their liberty without the safeguards in the 2003 Act and possibly in contravention of the Human Rights Act. We have also had concerns that the 2003 Act may be used too late and that people with dementia are left in situations of high risk to their own health and safety.

Diagnoses of people aged 65 and over where CTO was granted 2008-09 and 2009-10

Fig-27b

*ARBD - alcohol related brain damage

 

We have recorded a 33% increase in CTOs for people with dementia, but only a 6% increase for people with functional illness. Although numbers are low, we are also seeing an increase in CTOs for people with ARBD. This increase is below statistical significance, but still an interesting trend. We will analyse this information further to look for geographical variations.