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Mental Health Act: Hospital based Place of Safety orders increase whilst police station orders decrease

October 29, 2014: Latest figures on detentions(2) under Section 136(3) of the Mental Health Act 1983 show that the reported number of Place of Safety Orders made where an individual was taken to a police station has decreased by 24 per cent(4), from 7,900(5) in 2012-13 to 6,000 in 2013-14.

*HSCIC must be quoted as the source of these figures

*Regional data to police force and hospital trust level available

Meanwhile, Place of Safety Orders made under Section 136 where an individual was taken to hospital increased by 21 per cent, from 14,100 in 2012-13 to 17,000 in 2013-14.

The Mental Health Act gives police powers to take people who appear to be suffering from a mental disorder to a 'Place of Safety' for assessment for up to 72 hours - in the interests of the health or safety of the person, or the protection of the public. After assessment, the person will either be taken to hospital if not already there and detained under another section of The Act, admitted informally to hospital, or released.  

Today's annual report - Inpatients formally detained in hospitals under the Mental Health Act 1983, and patients subject to supervised community treatment, England 2013-146 - shows that the total number of Place of Safety Orders made in 2013-14 was 23,3007 - a five per cent increase from 2012-13 (22,200).

The report provides information about the use of other sections of the Mental Health Act, such as Community Treatment Orders (CTOs) 8 and both long and short term detentions in hospital. It shows that the Mental Health Act was used 53,200 times in 2013-14 to detain people in hospital for longer than 72 hours. This is five per cent higher than during 2012-13 (50,400) and 30 per cent higher than 10 years ago (40,900).

A snapshot count taken on 31 March 2014, included within the report, shows that on that date:

  • 23,500 people were subject to the Mental Health Act, of which:

    • 18,200 were detained in hospital9
    • 5,400 were being treated in the community on CTOs
  • The rate of people detained was 33.7 per 100,000 population - an increase from 31.8 on 31 March 2013 and 28.0 on 31 March 2004.
     
  • The rate of people subject to a CTO increased from 9.8 per 100,000 population on 31 March 2013 to 10.0 on 31st March 2014.
  • The number of people subject to CTOs, as a proportion of all those subject to The Act, has increased since their introduction8 to around 23 per cent in March 2013 and March 2014. This compares to 17 per cent in March 2010, after CTOs had been available for a year.

Kingsley Manning, Chair of the HSCIC, said: "Today's report shows that Place of Safety Orders are being used over 400 times each week to take people to a hospital or a police station. The report also highlights changes in how Place of Safety Orders are being used, showing a clear shift from police based places of safety to hospital settings, which is useful information for mental health organisations and professionals."

You can view the full report at: http://www.hscic.gov.uk/pubs/inpatientdetmha1314

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. The Mental Health Act 1983 is the law under which someone can be admitted, detained and treated in hospital against their wishes.

Detentions under the Mental Health Act are defined in the report as:

  • Detentions on admission to hospital under Part II (Sections 2 and 3) and Part III of the Mental Health Act 1983, and under previous legislation (Fifth Schedule) and other Acts;
  • Detentions subsequent to admission (uses of Part II Sections 2 and 3, following a change of legal status from Section 4, 5 or informal stay in hospital);
  • Detentions under Part II Sections 2 and 3 following the use of Section 136;
  • Detentions following a Community Treatment Order (CTO) revocation.
  • Sections 135 and 136 are short-term detention orders (with a limit of 72 hours) made to a 'Place of Safety'.

3. Under Section 136 the Police can remove an individual to a 'Place of Safety' from a place to which the public have access. A warrant is not required. The Code of Practice for The Act recommends that the default Place of Safety should be a health based facility. Within these, emergency and specialist units should only be used where a medical problem requires urgent assessment and management.

A 'Place of Safety' (PoS) is defined for the purposes of The Mental Health Act as:

  • A hospital (including an independent hospital);
  • A police station;
  • A care home for mentally disordered patients;
  • Residential accommodation provided by a local social services authority under Part III of the National Assistance Act 1947;
  • Any other suitable place where the occupier is willing temporarily to receive the patient.

Whilst statistics from police custody databases are experimental, we are confident that police uses of Section 136 have decreased. The number of uses is known to be an undercount but recording has improved since 2012-13 and the scale of the undercount is expected to have reduced. Therefore the actual decrease is likely to be larger than reported.

4. Counts are rounded to the nearest 100 - exact figures are within the report. Percentages are based on exact figures and are rounded to the nearest whole number.

5. Revised since the 2012-13 publication to include an estimated figure of 120 for British Transport Police so that totals are comparable.

6. As part of our ongoing drive to improve collection methods and to reduce the administrative burden on the NHS, we are currently changing the way we collect statistics about the number of patients detained under the Mental Health Act and are working towards moving from a bespoke collection (KP90) to using administrative datasets such as the Mental Health Minimum Dataset (MHMDS).

During the transition period we have made the decision to produce statistics from both information sources. This allows us to assess the new method thoroughly before we fully transition. During the time we are using both figures, the report will be designated as an Official Statistic rather than a National Statistic, given the experimental nature of the new figures. Once we have completed the transition we hope to have the report re-designated as a National Statistic.

7. Figure includes Place of Safety Orders made under Section 135, of which there were 307 in 2013-14. Section 135 requires a warrant from a magistrate which allows the police to enter any premises to search for the individual. This includes patients who have gone absent without leave from detention in hospital and those who are believed to be suffering from a previously untreated mental disorder. More information on Section 135 is included within the report.

8. The Mental Health Act 2007 (which amended the Mental Health Act 1983) introduced Community Treatment Orders (CTOs, sometimes referred to as supervised community treatment) in November 2008.

Patients detained in hospital for treatment under Section 3 (and certain Part III Sections) can be discharged from detention onto a CTO to continue their treatment in the community. While on a CTO, they can, if necessary, be recalled to hospital for up to 72 hours for assessment and/or treatment ('CTO recall'). If after that time the patient is not sufficiently well to be released under their CTO, the underlying Section can be reinstated ('CTO revocation'). If a patient is discharged from CTO without revocation this is termed 'CTO discharge'.

9. 'Patients detained in hospital' refers to both longer-term hospital orders which last longer than 72 hours and short-term orders, which last up to 72 hours and include Place of Safety detentions in hospital under Sections 135 and 136.

10. Estimates of Section 136 Place of Safety Orders to police custody were based on figures extracted from the computer systems of individual police forces, for which there may be additional uncertainty due to variations in the precise definitions used. These statistics are therefore classed as 'experimental statistics'.

11. For media enquiries please contact media@hscic.gov.uk or 0300 30 33 888.

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