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Monitoring care & treatment

Quarterly statistics - third quarter, 2007

These provisional statistics were collected by the Commission for the period 1st July to 30th September 2007. Scroll down the page for detailed reports.

Summary

Emergency and short-term detention

There is a clear rise in the total number of new emergency orders granted by quarter, which is not what was hoped for under the new mental health Act. However, the quarterly total is still half the amount prior to the change in the law. 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.  There is no clear quarterly trend in numbers of short-term detentions. The number of people subject to community CTOs who are temporarily recalled to hospital seems to have stabilised, since the first quarter of the new Act.

The total number of detention episodes, initiated through emergency and short term detentions, is similar to the previous quarter.  There has been a rise in the number and proportion of these emergency orders where the person is subsequently returned to informal status, and not further detained under short-term detention (see episode patterns report below). Half the people subject to emergency detention were admitted directly from the community in this quarter, while the rest were informal inpatients. In short-term detention cases, 21% come directly from the community, while the rest are already in hospital, either as informal or detained in-patients. These patterns have not changed significantly between quarters. 

Detentions by administrative areas

The upward trend in emergency orders is apparent in some health boards and not in others. For example, emergency orders in Dumfries & Galloway and Forth Valley have increased, while Lothian figures have varied between quarters. Glasgow and Clyde figures have increased as expected following the health board boundary changes in April 2006. There are no clear trends in short-term orders by area.  

Young People

The number of admissions of under 18s to non-specialist facilities reported to us has risen sharply, to 50 cases this quarter. We think these admissions to hospitals across Scotland are undesirable, and we want to see health boards fulfil their duty to provide appropriate services for young people seeking admission for psychiatric treatment. The rise this quarter is seen in the 16-17 age group. The admissions were made to 21 different locations. The Commission plans to visit all individuals admitted under the age of 16, and 16-17 year olds who have been detained in accommodation which is not age-appropriate. 

Advance Statements

We were notified of 11 patients whose wishes expressed in advance statements have been over-ridden during this quarter. The Commission has recognised that it is a priority to monitor this aspect of the Act, but, as advance statements have been under-used in the first year of the Act, the number of over-rides doesn't tell us much about patient wishes being ignored. We think the potential of advance statements hasn't been fully realised by practitioners and service users and we would like to see practice develop in this area. We will be examining the different types of over-rides in more detail this year.

Point prevalence information

As expected under the new mental health Act, there are more people subject to community-based CTOs than at previous census dates. The proportion of women in the 'resident' detained population (36% in the July census) is lower than in new orders granted (47% of orders from July to September 06). This suggests that women are less likely to remain as detained patients. Their orders are more likely to be revoked or allowed to lapse.  The age distribution differs between men and women who are detained. For example, there are more men in the 25-34 age band by proportion, and more women in the 65-84 age band. Variation between health board areas in the rates of detention via criminal proceedings appears to reflect the forensic services available, and larger urban centres.

The proportion of returns of ethnic minority monitoring forms is not yet sufficient for reporting purposes. This is still an issue of concern.

Detailed statistics

Note: we cannot be absolutely certain that the quarterly figures notified to the Commission, and consequently reported by our IT system, are correct at date of publication. We will be working with the range of agencies responsible for supplying us with information to verify our statistics over the year.  Please see our Annual Reports for finalised figures.

 

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