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Mental health: New Guardianship cases increase slightly after three year decline

•Wide regional variation in numbers of Guardianship cases

*Regional figures are available

HSCIC must be cited as the source of these figures

September 10, 2014

The number of new Guardianship cases under the Mental Health Act rose by four per cent in England in 2013-14, according to a new Health and Social Care Information Centre (HSCIC) report.

Such cases totalled 290, a rise from 280 cases in 2012-13. This is the first rise in the number of new cases since 2009-10 (when 440 new cases were recorded).

The number of continuing cases2 was 600 at the end of March 2014, a decrease of four per cent from 2013-14. This is the ninth consecutive year of decline.

Guardianship3 allows a local social services authority or named individual to take certain decisions on behalf of a person with a mental disorder being cared for in the community, to protect their welfare or the welfare of others. Decisions might include where the person lives, or appointments they need to attend.

Today's report, Guardianship under the Mental Health Act, 1983, England, 2013-14 points to wide variations in the number of Guardianship cases across regions4, with 30 of 152 Local Authorities having no cases to report for this period. The report shows:

  • The North East had the highest number of new cases relative to its population, with 10.8 cases per million of the population, an increase from 8.1 cases per million population in 2012-13. This is double the England rate of 5.3 per million of the population.
  • The Eastern region had the fewest new cases relative to its population, with 1.8 cases per million of the population.
  • The North West had the highest number of new cases (64), accounting for 22 per cent of all the new cases in England.
  • The North West also had the highest rate of continuing cases, both in terms of the actual number of cases and rate of cases per million of the population. There were 160 continuing cases, accounting for 26 per cent of the total for England, giving a rate of 22.0 per million of the population.
  • London has the lowest rate of continuing cases, with 2.7 per million of the population.
  • The median duration to closure of Guardianship cases in England was1.9 months. The shortest duration reported was seven days and the longest was 30.3 years.
  • East Midlands reported the longest median duration for closed Guardianship cases, at 28.5 months.
  • London had the shortest median duration for closed Guardianship cases, at 6.0 months

Whilst the total number of Guardianship cases is demonstrating an ongoing decline, the number of patients cared for under other Mental Health legislation is increasing. Community Treatment Orders (CTOs) aim to promote the welfare of people who would otherwise be detained in hospital and Deprivation of Liberty Safeguards (DoLS)5 protect people who lack the capacity to make decisions about their own care or treatment and to ensure that they are only deprived of their liberty in a necessary and proportionate way. CTO cases increased by 13 per cent between 2009-10 and 2012-13, from 4100 to 4600 cases. The number of granted DoL applications nearly doubled in the same period (from 3300 to 6500 applications granted.)

Kingsley Manning, Chair of the Health and Social Care Information Centre said: "The number of Guardianship cases is generally declining and this may be because there is now alternative Mental Health legislation to care for patients with a mental health disorder who are a risk to themselves or others.

"Although we cannot state a direct cause and effect, the use of Deprivation of Liberty Safeguards (DoLS) and Community Treatment Orders (CTOs) has increased as the number of Guardianship cases has decreased. This could indicate that the changes to legislation have led to changes in local practice."

ENDS


Notes to editors

  1. The Health and Social Care Information Centre (HSCIC) was established on April 1 2013 as an Executive Non Departmental Public Body (ENDPB). It is England's trusted data source, delivering high quality information and IT systems to drive better patient services, care and outcomes. Its work includes publishing more than 220 statistical publications annually; providing a range of specialist data services; managing informatics projects and programmes and developing and assuring national systems against appropriate contractual, clinical safety and information standards.
  2. A reporting year runs from the 1st April until the 31st March. A continuing case is one that either began in a previous reporting year and is still continuing at the end of the current reporting year, or has begun in the current reporting year and is still open at the end of it. A new case is one that has been opened during the current reporting year. A closed case is one that ends during the reporting year, however the case may have opened in the current or a previous reporting year. Cases that were opened during the current reporting year and are still open at the end of it will therefore appear in both the 'new cases' and the 'continuing cases' counts. Cases that were opened during the current reporting year and also closed within the current year will appear in both the 'new cases' and the 'closed cases' counts.Some inconsistences in the time series figures in this release arise because of revisions to previous years and other issues relating to the reliability of historical data. These are described in the Background Quality Report that accompanies the report.
  3. The purpose of Guardianship is to enable patients to receive care in the community where it cannot be provided without the use of compulsory powers. It provides a framework, as part of the overall care and treatment plan, for working with a patient to achieve as independent a life as possible. Guardianship applies to patients who are at least 16 years old and who have a mental disorder of a nature or degree which warrants reception into guardianship, and where it is also necessary in the interests of the welfare of the patient or for the protection of others.
  4. There are nine regions (formerly known as Government Office Regions) in England. These are the North East, North West, Yorkshire and the Humber, East Midlands, West Midlands, East of England, London, South East and the South West.
  5. Deprivation of Liberty Safeguards (DoLS) were introduced in April 2009 (under the Mental Capacity Act). The latest published HSCIC report includes data up to and including 2013/14 and was published on 3 September 2014. This can be found at www.hscic.gov.uk/pubs/mentcap1314annual  CTOs were introduced in November 2008 and the latest published CTO data are up to and including 2012-13. These can found at www.hscic.gov.uk/pubs/inpatientdetmha1213, with the 2013-14 data due for publication on 29 October 2014 by the HSCIC.
  6. Numbers above 100 have been rounded to the nearest 10, and above 1000 to the nearest 100. Percentages have been rounded to the nearest whole number.
  7. For media enquiries or interview requests please contact the press office on media@hscic.gov.uk or 0300 3033 888 - please note our change in media line number.
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