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Short-term detention under the Mental Health (Care & Treatment) (Scotland) Act 2003

 

Short-term detention certificates granted by age and gender 2009-10

 

AR-09-10-Table7

Our interest in this

Short-term detention certificates (STDCs) should be the usual start for an episode of compulsory treatment under the 2003 Act. An STDC involves examination by an approved medical practitioner (AMP) and consent from a mental health officer (MHO). It can last for up to 28 days. We look at how this power is used for people of different ages and genders to see if there is evidence of unequal treatment. We also compare this data with previous years to see if there are any trends. Last year, we commented on an increase in the use of STDC for people aged 65 and over

What we found

Overall, there has been a slight rise in the use of short-term detention in the last three years (about 3%). Unlike emergency detention, we found the gender balance in the use of STDCs roughly equal and with very little change over the past few years.  Women over 65 are more likely to be detained on a short-term detention then men in the same age group. Men under 25 are more likely to be detained using a STDC than women of the same age.

As with emergency detention, we are seeing a rise in the use of STDCs for people aged 65 and over. Compared with 2007-8, there has been a 14% increase in the number of people aged 65 and over detained on STDC while the number of people under 65 in this category has remained stable. Over the past three years, we have commented on an increasing tendency to use mental health legislation for older adults. The use of EDCs in this age group contrasts with a reduction in their use for younger people. As yet, there is not a significant overall rise in the older population. We think the increased use of the 2003 Act reflects the attention given to the rights of people with dementia. If the person cannot consent to hospital admission and is voicing or expressing resistance, detention may be more proper than informal admission. Also, it may be that services are trying to manage people with dementia for longer in the community and need to intervene quickly when services are insufficient to deal with the risks faced by the person with dementia. The lack of a power to intervene quickly under the Adults with Incapacity (Scotland) Act 2000 may also be an issue here.

The use of STDCs for people under 18 is higher this year than last. It fluctuates year by year with no overall trend.

 

Number and percentage of short-term detention certificates granted by type of mental disorder specified 2009-10

 

 AR-09-10-Table8

Our interest in this

We want to know the type of mental disorder(s) specified on STDC forms. The 2003 Act defines "mental disorder" as "mental illness, learning disability or personality disorder". A person may have more than one type of mental disorder. Generally, most people are detained because of mental illness.

What we found

We found an increase in the number of people recorded as having learning disability or personality disorder. This may reflect greater awareness of recording these conditions on the STDC forms. Additional information regarding the use of mental health legislation for people with a learning disability will be available from our 2 yearly census. We will continue to monitor the use of mental health legislation for this group of people.

STDs granted where named person is recorded or consulted 2009-10

AR-09-10-Table10

Our interest in this

The concept of each person having a 'named person', who would have an interest in the care and treatment of a person with mental disorder, was an important aspect of the 2003 Act. The right to be consulted over the proposed granting of an STDC is an important part of the named person's role. We have been disappointed that this has occurred in fewer cases than we wish to see.

What we found

There has been a steady increase in the number of STDCs where the named person has been consulted. This year, the named person has been consulted in more than half of cases. This is heartening but could be higher still. In most cases at present the person will have a designated named person, even if he or she has not nominated an individual to the role.  The 2003 Act sets out who can act as a 'default' named person. It is the duty of the MHO to identify the named person. The MHO should also consult with medical and nursing staff to identify the named person and to ensure that everyone is aware of who that is. The AMP must consult the named person unless it is impracticable to do so.