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Monitoring care & treatment
Quarterly statistics — January to March 2008
These provisional statistics were collected by the Commission for the periods 1 January to 31 March 2008. Scroll down the page for detailed reports.
Summary
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. There has been a slight increase in the total number of emergency detentions compared to the previous quarter's figures (472 compared with 444). Comparison with Table 4 in the previous quarter shows that most of the increase in emergency detentions occurred in the male 25-44 age group. However, Tables 7 – 22 show that emergency and short term detention numbers vary by health board and there is no consistent pattern of quarterly change.
Of more concern may be the increase this quarter (from 226 to 254) in the number of short term detention episodes which started with an emergency admission. This is in the context of an overall fall in the total number of episodes involving emergency or short term detention (from 993 to 970) (Table 58). There is also an apparent slight increase from previous quarters in the proportion of emergency detentions of informal patients and a decline in the proportion involving people living in the community (Table 59a). The proportion of informal patients detained on short term orders has also increased from the last quarter. These apparent changes will be re-assessed in the context of annual figures published in our annual report.
For Scotland as a whole, 69% of all emergency detention certificates (EDCs) granted in the quarter had the consent of a mental health officer (MHO), a slight increase. The law says that MHO consent for emergency detention should be sought where practicable. Just under one third of EDCs in Scotland did not have MHO consent. There has been little change in these proportions over the past 4 quarters and the wide variation between NHS boards persists (Table 79). 68% of certificates were granted out of hours (Table 80). 69% were granted out of hours. Table 80 suggests that Lanarkshire and Dumfries and Galloway have granted more than half of their EDCs in the quarter without MHO consent.
Community-based compulsory treatment orders (CCTOs)
There are fewer new community-based CTOs in the latest quarter, but a sharp increase in cases of variation from a hospital to a community-based CTO (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
The number of admissions of under 18s to non-specialist facilities reported to us has risen in the first quarter of 2008 (Figure 2) compared with the previous quarter. The total for the January to March 2008 quarter is 37. This includes eight under-16 admissions compared with one in the previous quarter. We continue to give high priority to encouraging health boards to fulfil their duty to provide appropriate services for young people requiring admission for psychiatric treatment. See HDL 2005 (55) (.pdf) 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 tells us little about patient wishes being upheld. Recent analysis of report of our visits to people subject to compulsory treatment orders suggests that around 10% of people in this sample of the detained population had made advance statements. The number of times advance statements are overridden has varied from 11 – 16 over the last four quarters. 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
At the start of every quarter we use our database to conduct a census of people subject to compulsory powers on the selected date. On the January 2008 census date, a total of 2,539 people were subject to compulsion. Comparing the latest figures with previous quarterly censuses, we observe that the rate of increase in the number of people subject to CTOs based in the community continues to slow (Table 64; Figure 3). The numbers on short term detention appear to be falling (Table 64).
Adults with Incapacity Act activity
The total number of applications for welfare guardianship made in the last quarter of 2007 is 293. The Commission was notified of 230 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).
70% of orders were granted for an indefinite duration.
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 (.doc)
Orders granted by Health Board (.doc)
Orders granted by Local Authority (.doc) of the Mental Health Officer
Episode patterns and pre detention status (.doc) — the sequence of orders in episodes of detention and status prior to detention e.g. from informal hospital care, or from the community
Advance Statement Overrides (.doc) — notifications of over-rides of patients wishes
Admissions of young people to non specialist wards (.doc)
Point Prevalence (.doc)
AWI welfare guardianship activity (.doc)
Emergency detention and MHO consent (.doc)
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.
Quarterly statistics