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Monitoring care and treatment
Quarterly statistics report 1st July to 30th September 2008
Summary statistics are given in the text, links to detailed statistics can be found at the bottom of the page.
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.
For Scotland as a whole, 67% of all emergency detention certificates (EDCs) granted in the quarter had the consent of a mental health officer (MHO). 71% were granted out of hours (Table 80).Overall, 33% of EDCs in Scotland did not have MHO.
The law says that MHO consent for emergency detention should be sought where practicable.Table 79 shows variations between NHS board areas.Ayrshire and Arran and Lanarkshire show a relatively high proportion of EDCs granted out of hours without MHO consent at 34%, followed closely by Greater Glasgow and Clyde and Dumfries and Galloway at a rate of 33%.
There has been a slight decrease in the total number of detention episodes, initiated through emergency and short-term detentions, between the Jul–Sep 08 quarter and the last quarter (Table 58)
Over the 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). There has been a slight increase in numbers of individuals prior to emergency detention coming from the status of an informal patient, 232 last quarter to 276 this quarter. There has been a slight decrease in those coming directly from community to emergency status, 226 this quarter compared to 211 last quarter.
Community-based compulsory treatment orders (CCTOs)
There are fewer new community-based CTOs in the latest quarter, while variation from a hospital to a community-based CTO has remained unchanged over the last three quarters (Table 2), but see notes on the data. The number of people subject to community CTOs, who are temporarily recalled to hospital, shows little variation. The same is true for people on community based compulsion orders (Table 3).
Young people
Following a dip in numbers reported in the last quarter of 2007, the number of admissions of young people to non-specialist facilities reported has remained constant for the first three quarters of 2008 (Figure 2). The 'under 16' figures in this quarter have remained the same as last quarter and there has been a slight decrease in the 16-17 year age group.
The total number for the July to September 2008 is 38.These admissions took place across all NHS areas (excluding island authorities).
In the third quarter of 2008, 71% of all under-18 psychiatric admissions to non-specialist facilities occurred in adult psychiatric wards (Table 62).
Advance statement over-rides
The number of notifications of advance statements being over-ridden continues to be low and is decreasing.We follow up all reported over-rides of patient wishes recorded in advance statements.
The Commission has recognised that it is a priority to monitor this aspect of the Act, but, as advance statements have been little used, the number of over-rides tells us little about patient wishes being upheld.We think the potential of advance statements has not been fully realised by practitioners and service users and we would like to see practice develop in this area.
Point prevalence information
We are continuously striving to improve the way we record and capture statistical information. In this quarter, we re-ran point prevalence statistics for the previous three quarters. There were some differences between the old and new sets of figures and therefore figures published in this report will not match point prevalence statistics published previously.
Point prevalence figures published for this quarter are preliminary as, at the moment, we have low confidence in their accuracy, We will be changing the way we gather and monitor these statistics and will provide updated information when it becomes available.
December 2008
On the July 2008 census date, a total of 2576 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 (Table 65).There was little difference between the numbers of women to that of men, subject to compulsion on the census date, who were on short-term orders. 53% of women and 44% of men were on hospital based CTOs. 19% of women and 18.5% of men were on community-based CTOs.
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 are less likely than men to remain as detained patients. As in previous point prevalence statistics, the age distribution on 2 July 2008, 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 45-64 and 65-84 age bands than men.
Adults with Incapacity Act activity
The total number of welfare guardianship applications notified to the Commission in the third quarter of 2008 was 337.During the same period, 267 applications were granted.For Scotland as a whole, there are now substantially more private welfare guardianships granted, than where the local authority is the applicant (Table 70).
267 welfare guardianship interlocutors were received during the quarter (Figure 4) compared with 250 last quarter.The proportion of relative or carer applicants in interlocutors received during the most recent quarter is slightly higher at 60% than in the previous quarter when it was 53% (Table 71). 42% of all orders included both welfare and financial powers (Table 73).Women account for 61% of all interlocutors received in the quarter.In this quarter, 63% of women subject to welfare guardianship were over 65 years old (Table 74).
The proportion of orders granted for an indefinite duration continues to be very high at 70%, a slight decrease from last quarter where the figure was 78%. 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 at 79% (Table 76) remains largely unchanged from the previous 2 quarters of 2008 where the figures were 75% and 80% respectively.
Criminal proceedings
No community-based compulsion orders were granted in this quarter. The numbers of orders granted under criminal proceedings are very small by quarter. More detailed information is presented in our annual reports
Ethnic monitoring
The proportion of returns of ethnic minority monitoring forms is not yet sufficient for reporting purposes. We continue to be concerned that we are not able to report on this. We will be looking at other options for monitoring ethnicity in relation to the use of mental health legislation this year.
Detailed Statistics
Orders granted by type, age, gender across Scotland (Tables 1-4; Figure 1)
Orders granted by health board (Tables 7-22)
Orders granted by Local Authority (Tables 23-56)
Episode sequences and pre-detention status of orders status of orders in episodes of detention and status prior to detention.g.from informal hospital care,or from the community. (Tables 58-59b)
Advanced statement overides- notifications ofover-rides of patients wishes (Table 60)
Admissions of young people to non-specialist facilities (Table 62; Figure 2)
Point prevalence people subject to compulsion on census date of 2 July 2008. (Table 64-67, Figure 3-4b)
Welfare guardianship welfare guardianship activity (Tables 70-76; Figure 5)
Emergency detention and Mental Health Officer consent by time granted (Tables 79-80)
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.
