The number of new episodes of compulsory treatment for mental ill health in Scotland in 2014/15 rose to the highest level since 2005, when the current Mental Health Act was introduced, according to new statistics.
There were 4,851 episodes of new compulsory treatment in 2014-15, a 7% rise on the previous year, according to a report by the Mental Welfare Commission. When doctors use the law to provide compulsory care or treatment for mental ill health, they must inform the Commission.
There are two main ways for new compulsory treatment to be initiated, either through emergency detention, or short-term detention. There was a marked difference between health board areas in the way they follow the procedure the law sets out for emergency detention, with Greater Glasgow and Clyde showing the lowest rate of having the consent of a specialist social worker. While this is not legally binding in every case, it is a strong safeguard for the person who is unwell and about to be hospitalised against their will.
Key facts from the report include:
• An emergency detention certificate can be issued by any registered medical practitioner, and last up to 72 hours. It is usually used out of office hours. To safeguard the patient, the Act specifies that there should also be consent from a mental health officer – a specialist social worker – when possible. In Greater Glasgow and Clyde, the area with the highest use of these certificates, only 28% of emergency detentions had the consent of a mental health officer. This compares with 80% in Tayside and 60% in Lothian
• The increase in new compulsory treatment is largely due to an increase in using the Act to admit older people to hospital. While numbers of emergency detention certificates for most age ranges dropped last year, they rose by 19.2% for 65-84 year olds. There was an 18.4% rise in short-term detentions issued for people aged 65-84, and a 16.5% rise for those aged over 85
• Looking at the overall rates per head of population of people who are subject to any form of compulsory treatment on a given day, Greater Glasgow and Clyde is highest, followed by Tayside, Fife and Lothian
• Highland also has a relatively high use of compulsory treatment. Dumfries and Galloway, Lanarkshire and Borders have low levels of compulsory treatment.
Colin McKay, chief executive of the Mental Welfare Commission, said: “The reasons for the rise in compulsory treatment for people with mental ill health are unclear. It could be due to increased diligence amongst doctors in using the legislation appropriately. That, in turn, could reflect greater awareness of patients’ rights and the need to avoid unlawful deprivation of liberty. Or it could be that with the increased emphasis on community care, people are more unwell when they need to come into hospital.
“One thing we are clear on, is that the pressure on mental health officers is continuing. We were very concerned to see the low rates of consent from mental health officers across many parts of the country, and in Greater Glasgow and Clyde in particular.
“It is unfair for vulnerable people to find that the area of the country in which they live plays such a central role when it comes to knowing whether they will get the support of these specially trained social workers in a crisis situation. They can help make a difficult and frightening situation a little bit easier, and may be able to find ways to avoid the use of detention altogether. We will push the Scottish Government and local authorities to do more to encourage more people to train for this role, and put more resource to go into supporting that training.”