Quarterly statistics
Summary
These provisional statistics were collected by the Commission for the period 1 July to 30 September 2009.
We cannot be absolutely certain that the quarterly figures notified to the Commission, and consequently reported here, are correct at date of publication. This applies particularly to Compulsory Treatment Orders and guardianship figures where notifications are subject to delays. We work continually with the range of agencies responsible for supplying us with information to verify our statistics. Please see our Annual Reports for finalised figures.
Emergency and short-term detention
The Code of Practice, which supports good practice under the 2003 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.
Rates of short-term orders granted have changed little in the quarter, remaining highly variable between local authority areas. Excluding the island authorities, rates range from 22 per 100,000 population in Angus, to 119 per 100,000 population in Glasgow City .
For Scotland as a whole, 63% of all emergency detention certificates (EDCs) granted in the quarter had the consent of a mental health officer (MHO). 68% were granted out of hours (Table 80). Overall, 37% of EDCs in Scotland did not have MHO consent. In the previous quarter the corresponding figure was 30%.
There is considerable movement of MHO's between local authority areas, to provide out-of-hours services. For this reason, we do not publish rates of emergency detentions by area, or attempt to compare areas.
Over the last four quarters reported there have been only slight variations in the proportions of informal inpatients made subject to emergency detention compared with those admitted directly from the community (Table 59a).
The law says that MHO consent for emergency detention should be sought where practicable. Table 80 shows variations between NHS board areas: Ayrshire and Arran shows a relatively high proportion of EDCs granted out of hours without MHO consent at 45%. In Island Health Boards numbers of EDCs are too small to allow meaningful comparison with other areas.
Community-based compulsory treatment orders (CCTOs)
The number of new community-based CTOs in the quarter reported to us is 28 down from 30 last quarter. However our point prevalence data (see below) suggest that there may be a gradual increase in the overall numbers of people on CCTOs.
Variations of existing hospital-based orders to community-based orders have fallen between quarter 2 and quarter 3 in 2009. There has been a decrease from 71 to 64 (Table 2).
People subject to community CTOs were temporarily recalled to hospital on 40 occasions. Thirty seven individuals were involved in these recalls.
Young people
In the quarter July - September 2009, we were notified of 47 young people being admitted to non- specialist facilities. 15% of these admissions involved children aged under 16. These admissions took place across all NHS areas (excluding island authorities).
For the last two quarters there has been a rise in the number of reported admissions of 16-17 year olds to nonâ€"specialist facilities. (Figure 2)
In the third quarter of 2009, 87% of all under-18 psychiatric admissions to non-specialist facilities occurred in adult psychiatric wards. (Table 62).
Advance statement overrides
At the start of every quarter we use our database to conduct a census of people subject to compulsory powers on the selected date. Figures for the last four quarterly censuses show a gradual increase in the number of people subject to CTOs based in the community but we cannot be confident at this stage that this represents a real trend. (Table 64; Figure 3). The numbers on short term detention vary marginally from quarter to quarter but the direction is not consistent. (Table 64).
On the April 2009 census date, a total of 2746 people were subject to compulsion. Gender and age patterns amongst the census populations have not changed little since the last report: 35% of people counted on the census date were women, 65% men. (Table 65). Similar numbers of women (116) and men (105) were on short-term orders. Of all those on hospital based compulsory treatment orders on the census date, 39% were female, 61% male. Of those on community based compulsory treatment orders 35% were female, 65% were male.
Of those subject to compulsory powers, men were more likely to be subject to criminal proceedings: 23% compared with 8% of women.
As pointed out in earlier reports, the fact that the number of women detained on our census dates has been consistently lower than that of men indicates that women who are detained remain so for a shorter time than men. The age distribution on 1 April, as shown in pie charts (Figures 4a and 4b), differs between men and women who are detained. For example, there are proportionately more men in the 25-44 age band than women, and proportionately more women in the 65-84 age band than men.
Table 66 shows rates of detention per 100,000 population by order type and health board area, and Table 67 shows actual numbers. Excluding island health boards (see notes), Table 66 shows variation in rates by health board area. Short-term detention rates range from 2 to 7 per 100,000 population. Hospital-based CTO rates range from 12 to 38, and are highest in Tayside, similar to previous census dates. Community-based CTO rates range from 8 to 17, and are highest in Dumfries and Galloway and lowest in Ayrshire and Arran, similar to previous census dates.
Adults with Incapacity Act activity
In the first quarter of 2009, 311 welfare guardianship applications were notified to the Commission. Consistent with the trend over the past 2-3 years, in Scotland as a whole, there are substantially more private welfare guardianships granted, than there are local authority ones (Table 70).
The proportion of relative or carer applicants in guardianships granted during the most recent quarter is 64% (Table 71). 48% of all orders included both welfare and financial powers (Table 73).
In previous quarters we have reported on Welfare guardianship orders granted, by age and gender. Analysis of cause of incapacity by age produces more useful data
We do not report on all causes of incapacity as some of the numbers are very small. What Table 74 shows is that in the 16-17 and 18-24 age groups, the percentage of guardianships granted where the cause is learning disability is very high, running at 94 and 92 respectively. Looking at causes of incapacity cited for welfare guardianships granted in the age group 85+, dementia is given as the cause in 96% of orders granted in the group. (Table 74)
The proportion of orders granted for an indefinite duration continues to rise and for this quarter stands at 75%, which has increased from the last quarter where the figure was 70%.
In 98% of orders granted, the power to determine care and accommodation (or where adult should reside) was included. The percentage of orders granted which include the power to give consent to medical treatments, research or supervise medication stands at 83% (Table 76). The corresponding figure for the previous quarter was 77%.
Detailed statistics
- Orders granted by type, age, gender across Scotland (Tables 2 and 4; Figure 1)
- Orders granted by Health Board (Tables 7-22)
- Orders granted by Local Authority of the Mental Health Officer (Tables 23-56)
- Episode sequences and pre-detention status - the sequence of orders in episodes of detention and status prior to detention e.g. from informal hospital care, or from the community. (Tables 58-59b)
- Admissions of young people to non-specialist facilities (Table 62; Figure 2)
- Point prevalence - people subject to compulsory powers on census date of 1st April 2009. (Table 64-67) (Figure 3 and figures 4a and 4b)
- Adults with Incapacity Act- welfare guardianship activity (Tables 70-76; Figure 5)
- Emergency detention and mental health officer consent, by time granted (Tables 79-80)
Notes:
- There is no table 1 or table 3 as we no longer report new CPSA orders quarterly and there is no table 60 as we no longer report quarterly on advance statement overrides
- Point Prevalence figures presented in table 64 for previous quarters are "re-run" figures. This means that there may be slight variations from those reported for previous census dates. Following analysis of the effects of time delay on point prevalence figures, it was decided that, while there was a little variation to figures over time, this was not sufficient to require delays in reporting.
