Q4_2009

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Quarterly statistics

Quarter 4 2009

These provisional statistics were collected by the Commission for the period 1 October to 31 December 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 CTO 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 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. They range from 25 per 100,000 population in Angus, to 120 per 100,000 population in Glasgow City.

For Scotland as a whole, 62% of all emergency detention certificates (EDCs) granted in the quarter had the consent of a mental health officer (MHO). Overall, 37% of EDCs in Scotland did not have MHO consent.

The law says that MHO consent for emergency detention should be sought where practicable. Lack of MHO consent is more common in out of hours situations.The proportion of EDCs granted out of hours without MHO consent ranges from 50% in Ayrshire and Arran to 0 in Borders and the Island Boards.

Over the four quarters reported there have been only slight variations in the proportions of emergency detentions involving informal patients as compared with the proportions involving people in the community.

Community-based compulsory treatment orders (CCTOs)

The number of new community-based CTOs in the quarter reported to us is 22 down from 28 last quarter.

In our quarter 3, 2009 statistics, we reported that, according to our point prevalence data, there may be a gradual increase in the overall numbers of people on CCTOs. In this quarter, there has been a decrease in the number of CCTOs granted from 652 to 644

Variations of existing hospital-based orders to community-based orders have fallen between quarter 3 and quarter 4 in 2009. There has been a decrease from 64 to 62.

People subject to community CTOs were temporarily recalled to hospital on 37 occasions. Thirty two individuals were involved in these recalls.

Young people

In the quarter October - December 2009, we were notified of 53 young people being admitted to non- specialist facilities.17% (9) of these admissions involved children aged under 16. These admissions took place across all NHS areas (excluding island authorities).

Over the last four quarters, there has been a rise in the number of reported admissions of 16-17 year olds to non-specialist facilities.In the fourth quarter of 2009, 79% of all under-18 psychiatric admissions to non-specialist facilities occurred in adult psychiatric wards.

Point prevalence information: numbers of people subject to compulsory powers

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 previous three quarterly census dates have been showing a gradual increase in the number of people subject to CTOs based in the community. In this quarter (Q4/09), there has been a decrease in CCTOs granted from 652 to 644. The numbers on short term detention vary marginally from quarter to quarter but the direction is not consistent.

On the October 2009 census date, a total of 2726 people were subject to compulsion.Gender and age patterns amongst the census populations have changed little since the last report: 35% of people counted on the census date were women, 65% men.Similar numbers of women (103) and men (110) 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 7% of women.

There are far more men than women for all people detained. A much higher number of men are on longer term detentions.

The age distribution on 7^th October 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.

Short-term detention rates range from 1 to 6 per 100,000 population. Hospital-based CTO rates range from 13 in Borders to 36 in Tayside, similar to previous census dates.Community-based CTO rates range from 8 to 16, and are highest in Fife and lowest in Ayrshire and Arran.

Adults with Incapacity Act activity

In the fourth quarter of 2009, 329 welfare guardianship applications were notified to the Commission.Consistent with the trend over the past2-3 years, in Scotland as a whole, there were substantially more private welfare guardianships granted, than there were local authority ones.

In 67% of applications notified, the applicant was a relative or carer.
51% of all orders included both welfare and financial powers.
The most common cause of incapacity in younger age groups is learning disability. In older age groups the main cause of incapacity cited is dementia.
The proportion of orders granted for an indefinite duration for this quarter stands at 71%. In 98% of orders granted, the power to determine care and accommodation (or where adult should reside) was included.

Mental Welfare Commission for Scotland