Statistics on the use of mental health legislation etc.
NHS Information Centre - main links
Mental Health page
NHS Information Centre - DOLS
- NHSIC, 'Mental Capacity Act 2005, Deprivation of Liberty Safeguards assessments - England, 2011-12, Third report on annual data' (17/7/12). Key facts: (1) There has been a year-on-year increase in the number of applications completed for Deprivation of Liberty Safeguards (DoLS) since the safeguards were first introduced in 2009/10. There were 11,393 applications in 2011/12, which represents a 27per cent increase on the 8,982 in 2010/11 and a 59 per cent increase on the 7,157 applications in 2009/10 (the first year of the new safeguards). (2) The number of people subject to a standard authorisation at the end of the quarter had increased each quarter since the safeguards were introduced, from 536 at the end of June 2009 to 1,976 at the end of December 2011. However, between the end of December 2011 and March 2012 the numbers decreased by 16 per cent, the first fall in numbers seen. (3) Dementia accounted for 53 per cent of all applications and this is reflected in the age profile of people who are the subject of DoLS applications. (4) Fifty-eight per cent of applications relate to people over 74 and the population-based rate of applications is much higher for over 74s and over 84s. For the over 84s the application rate is 25 in 10,000. This compares to 12 in 10,000 for 75-84 year olds, 3 in 10,000 for 65-74 year olds and just 1 in 10,000 for 18-64 year olds (working-age adults). (5) There are wide variations in population-based application rates by region. The East Midlands has the highest rate of applications at 51 per 100,000, whilst London had the lowest rate at just 17 per 100,000. These compare to a rate for England as a whole of 28 per 100,000.
- NHSIC, 'Bi-annual analysis of Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) - October 2011 - March 2012' (12/6/12). Key facts: The figures show that between 01 October 2011 and 31 March 2012: (1) 5,933 authorisation requests were completed. 4,255 (71.7 per cent) were received by LAs and 1,678 (28.3 per cent) were received by PCTs. (2) 3,277 (55.2 per cent) of the completed requests resulted in an authorisation. - 2,400 (56.4 per cent) of the assessments received by a LA resulted in an authorisation. - 877 (52.2 per cent) of the assessments received by a PCT resulted in an authorisation. (3) Of the total assessments completed, a slightly higher proportion was for females 3,190 (53.8 per cent) than males 2,743 (46.2 per cent). (4) At the end of the reporting period, 31 March 2012, 1,667 people were subject to a current standard authorisation. 1,421 (85.2 per cent) followed a granted LA authorisation and 246 (14.8 per cent) followed a granted PCT authorisation.
- NHSIC, 'Bi-annual analysis of Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England): April-September 2011' (2/12/11). The key facts are stated as follows: 'The figures show that between 1 April and 30 September 2011: (1) 5,472 authorisation requests were completed. 3,963 (72.4 per cent) were received by LAs and 1,509 (27.6 per cent) were received by PCTs. (2) 3,079 (56.3 per cent) of the completed assessments resulted in an authorisation. (3) Of the total assessments completed, a slightly higher proportion was for females 2,857 (52.2 per cent) than males 2,615 (47.8 per cent). (4) At the end of the reporting period, 30 September 2011, 1,697 people were subject to a current standard authorisation. 1,484 (87.4 per cent) followed a granted LA authorisation and 213 (12.6 per cent) followed a granted PCT authorisation.'
- NHS Information Centre, 'Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) - Second report on annual data, 2010/11' (20/7/11). The key facts (abbreviated) are: (1) The total number of applications made was still much lower than expected for the second year; (2) The number of successful applications resulting in an authorisation to deprive a person of their liberty was about the expected number, though a much higher percentage of applications than expected were successful; (3) About 2 per cent of applications that were not authorised involved situations where the person was nevertheless judged as being in a situation that amounted to a deprivation of liberty; (4) Of those authorisations that were granted, more then half (55 per cent) were for a person who lacked capacity because of dementia; (5) 57 per cent of those applications made to a Local Authority were granted when applying for a deprivation of liberty compared to 50 per cent in Primary Care Trusts; (6) Authorisations granted for people in care homes were generally for longer periods than for people in hospitals; (7) There is a big difference in the number and rate of applications in different parts of England.
- NHS Information Centre, 'Quarterly analysis of Mental Capacity Act 2005, Deprivation of Liberty Safeguards Assessments (England) Quarter 2 2010/11', 22/12/10. The summary states that these statistics provide the first official information about authorisations using the legislation. Key facts listed are: (1) the number of authorisations completed was 2,333 in quarter 2; (2) of the total assessments completed in this quarter, a higher proportion were for females than for males; (3) in quarter 2, 76 per cent of assessments were made by local authorities while the rest were made by primary care trusts; (4) the percentage of authorisations granted which led to someone being deprived of their liberty was 54 per cent in quarter 2; (5) at 30 September 2010 1,436 people were subject to such authorisations.
HSCIC - Guardianship
- NHSIC, 'Guardianship under the Mental Health Act 1983 - England 2011' (8/9/11). Key facts: (1) The number of new Guardianship cases fell by 22 per cent between 2009/10 and 2010/11 from 435 to 339 cases, which is the largest reduction in new cases since 2001/02, the first year analysed in this report; (2) For the fifth consecutive year there was a decrease in the number of continuing Guardianship cases open at the end of the year; (3) There are large regional variations in the rates of Guardianship usage; (4) Variations in the rate of Guardianship usage are also noticeable across different types of authorities; (5) These variations in Guardianship usage are also very apparent at Local Authority level
- NHSIC, 'Guardianship under the Mental Health Act 1983 - England 2012' (18/9/12). Key facts: (1) The number of new Guardianship cases fell by 5 per cent between 2010/11 and 2011/12 from 347 to 331 cases. This is a much smaller reduction than between the previous two reporting years, which saw a notable fall of 21 per cent, possibly attributable to the introduction of new Mental Capacity Act Deprivation of Liberty Safeguards and Community Treatment Order legislation. The number of new cases in 2011/12 was 31 per cent lower than in 2002/03 when 477 new cases were reported. (2) This is the seventh consecutive decrease in the numbers of continuing cases. The number of cases continuing at the end of the year decreased by 26 per cent (from 923 in 2002/03 to 682 in 2011/12). The number of cases closed during the reporting year was 357; a decrease of 33 per cent since 2002/03 from 534.
- HSCIC, 'Guardianship under the Mental Health Act 1983, England 2014-15, National Statistics' (5/8/15, updated 6/8/15)†. "This report contains information on the use of Guardianship under Section 7 and 37 of the Mental Health Act 1983, during the reporting period 1 April 2014 – 31 March 2015. It contains information on new, continuing and closed cases at national, regional and local authority levels and includes breakdowns by gender, Guardianship type, and local authority region. Key facts: (1) For the 2014-15 reporting period there were 212 new Guardianship cases. This is 86 fewer than in 2013-14, a decrease of 29 per cent. This decrease follows a 6 per cent increase between 2012-13 and 2013-14. This increase however had been preceded by three consecutive years of decline. (2) As at 31 March 2015, 522 people in England were subject to a Guardianship order. This is 108 fewer than at the same point in 2014; a reduction of 17 per cent. This is also the tenth consecutive year of decline in continuing cases from 948 cases in 2004-05 to 522 cases in 2014-15, a reduction of 45 per cent over this period. The decline in Guardianship usage may be due in part to the availability of other mental health legislation. (3) The number of closed cases reduced slightly compared to the previous year, with 301 cases closed in 2014-15 compared to 313 in 2013-14 (a reduction of 4 per cent). The number of closed cases has now reduced for five consecutive years, since the peak of 496 cases in 2009-10. This represents an overall reduction of 39 per cent since 2009-10. (4) The North West and North East regions had the highest rate of new cases per million-population, both recording 9.3 cases per million-population, falling from 11.1 and 13.5 respectively in 2013-14 (based on population figures for those aged 16 years and over). This compares to 4.8 new cases per million-population for England overall. (5) The East of England region had the fewest new cases with 0.8 cases per million-population, compared to 2.9 cases last year. This is also the only region with less than 2 cases per million-population. (6) The North West had the highest rate for continuing cases with 23.5 cases per million-population. The South East and London continue to have the lowest rate of continuing cases. The South East had 6.4 cases per million-population and London 3.7 cases per million-population, although London represents an increase compared to 2013-14. (7) The durations of the 301 Guardianship cases ending in 2014-15 ranged from less than 3 months (15 cases) to over 10 years (14 cases). Of the 287 concluded Section 7 cases, 72 per cent (206) had durations of less than 2 years. Of the 14 concluded Section 37 cases, 29 per cent (4) had durations of less than 2 years. The median duration of a Guardianship case in England was 12.0 months."
NHS Information Centre - Detention and CTO
- NHSIC, 'Inpatients formally detained in hospitals under the Mental Health Act 1983, and patients subject to supervised community treatment, Annual figures, England, 2011/12' (24/10/12). Key facts: (1) On the 31st March, 22,267 people were subject to detention or CTO restrictions under The Act in NHS and independent sector hospitals. This represents a 6 per cent increase since the previous year and includes 17,503 people were detained in hospital and 4,764 people subject to a CTO. (2) There were a total of 48,631 detentions in NHS and independent hospitals during 2011/12. This number was 5 per cent (2,283) greater than during the 2010/11 reporting period. Total detentions in independent sector hospitals increased by 21 per cent; a large proportion of this increase was attributable to a 45 per cent increase in uses of Section 2. (3) There were 4,220 CTOs made during 2011/12, an increase of 386 (10 per cent) since 2010/11. The number of CTO recalls increased by 30 per cent and it is estimated that around 70 per cent ended in a revocation (an increase of approximately 10 percentage points since last year). The rise in CTO recalls and revocations may be linked to the 6 per cent reduction (473) in uses of Part II Section 3 of The Act. (4) There were 15,240 uses of place of safety orders (Sections 135 and 136) in hospitals during 2011/12; this figure was 6 per cent (841) greater than during 2010/11. New experimental figures estimate that 8,667 orders were made in hospitals, accounting for at least 37 per cent of all place of safety orders. (5) This report also includes some new experimental analysis on The Act using data from the MHMDS quarterly data submission files as the data source.
- In-patients formally detained in hospitals under the Mental Health Act 1983 and patients subject to supervised community treatment, Annual figures, England 2009/10 - 5/10/10 - Their summary is: "This bulletin summarises information about uses of the Mental Health Act 1983. It includes information from high security psychiatric hospitals as well as from other NHS service providers and independent hospitals. The latest figures for 2009/10 show that 16,622 patients were detained in hospital at the end of the year, an increase of 3.4 per cent from last year. Taken together with the number of people on Community Treatment Orders (CTOs) at 31 March (3,325) these figures suggest that increasing numbers of people are being subject to restrictions under the Mental Health Act. The figures also show major changes in the number of formal detentions, uses of Place of Safety Orders and CTOs."
NHS Information Centre - Other
- NHS Information Centre, 'Mental Health Bulletin - Fourth report from Mental Health Minimum Dataset (MHMDS) annual returns, 2010' (11/1/11). Two of the key facts are that (1) 'The number of people who spent time in a mental health hospital rose by 5.1 per cent - the first increase in five years'; and (2) 'This rise was due to a 30.1 per cent rise in the number of people being compulsorily detained in hospital under the Mental Health Act, from 32,649 in 2008/9 to 42,479 in 2009/10. Some part of this increase was due to improved recording between 2008/09 and 2009/10, because a small number of trusts failed to provide MHA information in 2008/09. On a like for like basis, excluding the data for trusts that failed to return information in 2008/09, there was an estimated increase of about 17.5 per cent in the number of people being detained under the MHA - from 32,649 to 38,369.'
Annual Tribunal Statistics
- MOJ website: 'Annual Tribunals statistics' page
- Ministry of Justice, 'Annual Tribunals Statistics, 2011-12: 1 April 2011 to 31 March 2012' (28/6/12). The following paragraphs, together with their associated tables, are relevant to mental health: (1) 23. The adjournment and postponement rates for Mental Health have remained at the same levels as 2010-11 (but had previously fallen probably as a result of improved case management processes). In 2011-12, the adjournment rate was 7%, whilst that for postponements was 13%. (2) 25. Of the 222,900 total jurisdictional sitting days, 72% were for fee-paid judiciary and 28% were for salaried judiciary. The ratio of fee-paid to salaried judiciary varies by jurisdiction. In 2011-12, 97% of judicial sitting days for Mental Health were for fee-paid judiciary, whilst this was 15% for the Asylum Support tribunal. (3) 40. For the Mental Health jurisdiction, the time from receipt to disposal has been examined for the three main case types. Unfortunately, the reporting system is not able to produce analysis by single week of age, thus there is some inaccuracy regarding the median and lower and upper quartiles. 41. Given the statutory requirement for Section 2 cases to be listed within 7 days of receipt, it is not surprising that this type of case has the shortest clearance times. The waiting times have reduced when compared with previous periods due to improvements made in administrative processes.
Welsh Assembly Government
National Confidential Inquiry into Suicide and Homicide by People with Mental Illness
National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCI / NCISH):