Mental Welfare Commission for Scotland

Skip Navigation

You are here: monitoring care & treatment  >  quarterly statistics  >  Quarterly statistics Oct-Dec 2007

Quarterly statistics

These provisional statistics were collected by the Commission for the periods 1October to 31 December 2007. Scroll down the page for detailed reports.

Summary

Emergency and short-term detention

The number of new civil orders granted shows little variation in the last quarter compared to previous periods (Figure 1).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.

The total number of detention episodes, initiated through emergency and short-term detentions, are similar in the October to December 2007 quarter, compared with the previous three quarters (Table 58). In all four quarters reported below, approximately half the people subject to emergency detention were admitted directly from the community, while the rest were informal inpatients (Table 59a).People coming directly from the community accounted for a third of all cases of people being subject to short-term detentions in the last quarter.There is an apparent increase over the year in the proportion of people subject to short-term orders from the community. This appears to be matched by a fall in the proportion of short-term orders applied to people already detained (i.e. on emergency detention orders). However, the differences between quarters are not significant at a 95% confidence interval of the mean.

For Scotland as a whole, 65% of all emergency detention certificates (EDCs) granted in the quarter had the consent of a mental health officer (MHO). The law says that MHO consent should be sought where practicable. 69% were granted out of hours (Table 80). Just under half of all EDCs were granted both out of hours, and with MHO consent, in the October to December 2007 quarter (Table 79). Just over one third of EDCs in Scotland did not have MHO consent. There are variations in proportions between health board areas. Table 80 shows that Lanarkshire has a much higher proportion of orders without MHO consent (68%); Lothian, Tayside, Grampian and Forth Valley have above average percentage of orders with MHO consent.

Community-based compulsory treatment orders (CCTOs)

The numbers of cases of variation of a CTO from a hospital to a community-based order, and of new community-based CTOs appear to be stable by quarter (Table 2), although the prevalence of community CTOs continued to increase (Table 64). Community-based CTO prevalence rates (per 100K population) range from 4 to 11 by NHS board area, and are highest in Lothian and Fife. This is similar to the last two census dates. The number of people subject to community CTOs, who are temporarily recalled to hospital, appears stable.

Detentions by local authority and health board areas

In most areas, the numbers of orders have fluctuated over the period covered in this report which shows rates of detention per 100,000 population for the year to 31/12/2007.Rates vary considerably between health boards. Excluding island areas (see notes), emergency detention rates vary from 15 (NHS Borders) to 58 (NHS Dumfries & Galloway). Short-term detention rates vary from 42 (NHS Lanarkshire) to 76 (NHS Greater Glasgow and Clyde). Rates in some health boards continue to be relatively low or high over time (see previous quarterly reports).

The rates of short-term orders granted range from 30 per 100,000 population in North Ayrshire, to 101 per 100,000 population in Glasgow City (excluding the island authorities). Glasgow City had the highest rates of short-term orders in all quarterly periods so far.

Young People

The number of admissions of under 18s to non-specialist facilities reported to us has reduced in the last quarter of 2007 (Figure 2). The total for the October to December 2007 quarter is 24. On a positive note there was just one under-16 admission reported in the quarter. We think any such admissions to hospitals across Scotland are undesirable. We want to see health boards fulfil their duty to provide appropriate services for young people requiring admission for psychiatric treatment. See HDL 2005 (55) advising health boards of duties in relation to this monitoring.

Advance Statement over-rides

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 doesn't tell us much about patient wishes being upheld.Our visits to people subject to compulsory treatment orders during 2007 show that around 8% of people in this sample of the detained population had made advance statements.The number of times advance statements are overridden is fairly consistent by quarter (around 13). 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.We will be examining the different types of over-rides in more detail this year.

Point prevalence information

This is information about the number of people subject to compulsory powers on the census date (3 October 2007). The number of people subject to CTOs based in the community continues to increase, compared with previous census dates, although the rate of increase is slowing (Table 64; Figure 3). On the October census date, a total of 2554 people were subject to compulsion.

Gender and age patterns amongst the census populations have changed little since the last report. Women who were subject to compulsion on the census date were more likely to be on short-term orders than men. Similar proportions of men and women are on community-based CTOs. Men were more likely to be subject to criminal proceedings. 36% were women on the census date (Table 65). We reported (Table 4) that 53% of new emergency and short-term orders made during the October to December quarter of 2007 involved women. The fact that the proportion of women detained on our census dates has been consistently lower than this suggests that women are less likely to remain as detained patients.

Table 66 shows variation in rates by health board area (excluding island health boards).Short-term detention rates range from 3 to 7.Hospital-based CTO rates range from 12 to 29, and are highest in Tayside, Lothian and Fife, similar to previous census dates. Community-based CTO rates range from 4 to 11, and are highest in Lothian and Fife, similar to the last two census dates.

Adults with Incapacity Act activity

The total number of applications for welfare guardianship made in the last quarter of 2007 is 279. The Commission was notified of 250 welfare guardianship orders granted during the quarter. We report on trends by quarter in Figure 5.

For Scotland as a whole, there are consistently more welfare guardianships granted where the applicant is a relative or carer, than where the local authority is the applicant (Table 70).

The proportion of applicants who were relatives or carers in the quarter (60%, Table 71) was similar to the proportion of appointed welfare guardians (Table 72). In 10% of all orders granted, an interim order was sought. 46% of all orders included welfare and financial powers, as opposed to welfare powers alone (Table 73). For five consecutive quarterly periods, 58-60% of all orders granted related to women. In this quarter, 63% of women subject to welfare guardianship were over 65 years old.

68% of orders were granted for an indefinite duration. In 97% of orders granted, the power to determine care and accommodation (or where adult should reside) was included (Table 76). The rank order of the use of these powers has remained much the same between quarterly reports.

Criminal Proceedings

No community-based compulsion orders were granted in this quarter. There were 3 variations of existing hospital-based orders to community-based orders, and 3 recalls of this group to hospital. The numbers of criminal proceedings granted are very small.

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.

Orders granted by type, age, gender across Scotland (Tables 1-4; Figure 1)

Orders granted by NHS Health Board (Tables 7-22)

Orders granted by local authority of the Mental Health Officer (Tables 23-56)

Episode patterns 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)

Advance statement overrides notifications of over-rides of patients wishes (Table 60)

Admissions of young people to non-specialist wards(Table 62; Figure 2)

Point prevalence– people subject to compulsion on census date of 3 October 2007. (Table 64-67, Figure 3-4b)

 Adults with incapacity- welfare guardianship activity (Tables 70-76; Figure 5)

 Emergency detention and MHO 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.