Chief Executive's Introduction 2010-11
Our reports on the use of mental health and incapacity legislation.
Each year, we look closely at how the legislation is being used to provide care, treatment and support for people with mental health problems or learning disability. You can find detailed reports on our website. Here are the most important findings this year.
The Mental Health (Care and Treatment) (Scotland) Act 2003
This year, we found an increase in the number of new episodes of treatment under the 2003 Act. We were notified on 4304 new episodes compared with 4096 the previous year, a 6% increase. This was surprising because the number of new orders had been falling since the 2003 Act came into force.
Overall, the total number of people on long-term orders has not changed much. The number of people subject to long-term community orders continues to rise while the number of orders for treatment in hospital continues to fall. We think this is a good thing, although we have found that more people have been readmitted to hospital from community orders this year.
We found that the use of emergency and short-term detention certificates for people under 18 rose by 50% and 34% respectively, most notably for girls. Many of these young people were detained because of concerns about suicide risk. Publicity about recent suicides of young people may have resulted in practitioners using the Act more if there were concerns about possible suicide. There was a rise in the use of longer term compulsory treatment orders for young people of both genders.
We were pleased to see a drop in admissions of young people to non-specialist wards. These admissions had reduced in most NHS Board areas but had increased significantly in Grampian. The reduction is still a long way short of the commitment of 50% reduction in "Delivering for Mental Health".
We found that black people appear to be more likely to be treated under the Act. Our data on this is incomplete and we are comparing it with 2001 census data. We hope to provide better information in the future.
We look carefully for variations among NHS Boards and local authorities. This year, we found that:
People in Dumfries and Galloway are more likely to be detained under emergency detention certificates without assessment by both a specialist doctor and specialist social worker. These orders should be used as seldom as possible.
People in Ayrshire admitted under emergency detention certificates are least likely to have consent from a social work mental health officer (MHO). This is important because the MHO can help to look for ways to support the person without the need for emergency admission.
People in Glasgow are more likely to be detained under short-term detention certificates. This could be explained by high levels of mental illness in deprived areas and availability of street drugs.
People in Glasgow are also most likely to receive long-term compulsory treatment. The rate of compulsory treatment is more than double the rate in the Borders.
Very few people in the Borders receive long-term compulsory treatment in hospital. They are more likely to be treated in the community than people in any other part of Scotland
The Adults with Incapacity (Scotland) Act 2000
We found a 14% increase in the number of appointments of welfare guardians. The rise is due to the number of private individuals (as opposed to Chief Social Work Officers) appointed as guardians. Over half of these orders were for indefinite periods of time. This means that there is no automatic review by a court or tribunal. These orders may deprive people of their liberty for long periods of time. We are working closely with the Scottish Government and others to examine the human rights implications of indefinite orders.
Other findings on the use of welfare guardianship include:
Glasgow city has the highest rate of new guardianship orders.
Dundee City had the highest proportion of indefinite orders.
The rise in the use of guardianship appears to be mostly for people with dementia.
