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New orders granted

 

New episodes of civil compulsory treatment initiated 2006-2010

 

AR-09-10-Table1

*NB These figures exclude people admitted to hospital from community based compulsory treatment

 

Our interest in this

This table shows how people enter a spell of compulsory treatment. We want to see how episodes start and what happens to people after they are first detained. Short-term detention should be the usual route into compulsory treatment. We want to find out whether this is what happens. In previous years, we found some general trends. The number of new compulsory episodes was falling, especially episodes initiated by emergency detention. Short-term detention, as a route into compulsion, had not been possible under the previous Act and looked to have been running at a consistent level since the 2003 Act was introduced.

This year, we have looked at these trends from the first full year after the implementation of the Mental Health (Care & Treatment) (Scotland) Act 2003.

What we found

We were notified of 4,069 episodes of compulsory treatment during the year. This number has fallen consistently since the 2003 Act was introduced. Compared with the first full year of the 2003 Act (2006-7), 7% fewer people are being placed on compulsory care and treatment orders. Compared with the previous Act, the drop is 15%. We believe that the more rigorous procedures, tighter grounds for compulsion and better expert assessment, and possibly more responsive community services, have reduced the need for compulsory treatment and we are pleased that the number continues to fall.

The biggest drop this year was the number of people detained only under an emergency detention certificate. The drop of 18% suggests that services are finding better ways to respond to people in mental health crisis. The fact that admissions under short-term detention certificates has not gone up, suggests that better crisis planning and management reduces the need for compulsory intervention. Also, despite a rise last year, the number of new orders under criminal procedures legislation has been relatively stable. This is reassuring as we would not wish to see people enter the criminal justice system when treatment under civil powers is appropriate.

There has also been a drop in the number of people who go straight onto a CTO. There is a higher percentage of community-based orders in this group. The two figures below show the trend in the use of new orders over the last four years.

 

New episodes of civil compulsory treatment initiated 2006-2010

Fig1a-Sequencing

 

Trend in the initiation of compulsory treatment episodes 2006-10

Fig-1b-Sequencing

 

 

Order sequencing 2009-10  

 visiodiag

 

Our interest in these figures

We want to see the pattern of how people progress from one order to the next. We also want to see the stages where orders lapse or are revoked. People should not be treated under compulsory powers any longer than is necessary.

What we found

  • 42% of all emergency detention certificates are revoked or lapse at or before 72 hours.
  • 72% of all short-term detention certificates are revoked or lapse at or before 28 days.
  • 14% of all orders granted by the Tribunal following application for compulsory treatment orders are interim orders only and do not progress to a full CTO.
  • 11% of all new CTOs are "community" orders, but 38% of people who go straight to a CTO from informal are being treated in the community.

Most people treated under the 2003 Act are detained and treated for short periods. We have reported on our visits to people on short term detention certificates and have commented on the need for frequent review of the need for the order. Most people who are detained each year will never have their cases reviewed by the Tribunal. The Commission has a vital role to visit these people and/or give advice and guidance to them and those caring for them.