A new report shows 6,038 new episodes of compulsory treatment using the Mental Health Act in Scotland last year – the highest figure since the Act came into force in 2003.
The new data, published by the Mental Welfare Commission, also shows rising figures for young people aged under 25 being given compulsory treatment.
The rates at which detention was used varied considerably across Scotland.
Young people
For the first time, the female age group with the highest rate of emergency detention certificates per 100,000 population was young women aged 18 to 24, totalling 185 certificates in the year. This compares with 105 for the same age group in 2009/10.
Young men age 16 to 17 have seen the greatest increase in rates of emergency detention per 100,000 population in the past year, and both young men and women aged 16 to 17 have shown the greatest increase in the rate of emergency detention across the 10 year period observed.
There has also been a rise in the number of short term detention certificates used in relation to young people. In women under the age of 25, there has been a 122.5% increase in the use of short term detention since 2009/10, rising from 142 to in 2009/10 to 316 in 2018/19.
Variation across the country
Greater Glasgow and Clyde Health Board continues to treat more people per rate of population than any other health board using both emergency and short term detention. This has been an ongoing feature for 10 years.
Dumfries and Galloway remains above average, but in recent years is reducing its use of emergency detention in particular.
The use of new compulsory treatment by Tayside Health Board has risen markedly in the last two years and is above average for both emergency detention and short term detention.
The five health boards who issue fewer detention certificates than the national average are Highland, Ayrshire and Arran, Lanarkshire, Borders and Grampian.
Low counts for the island health boards means their data is not easily comparable.
Dr Moira Connolly, interim executive director (medical), Mental Welfare Commission, said: “These figures show a continued rise in the use of detention under the Mental Health Act in Scotland. Compulsory treatment can, of course, be essential for the assessment and treatment of a person who is very unwell, but it does restrict an individual’s rights, and must always be used with careful consideration.
“The variation in rates of use across the country is an issue we again highlight and invite health boards to examine.
“The rise in numbers of times detention is used in relation to young people is concerning. We already know of the increased number of children and young people seeking help for mental health issues, but we need to understand more about whether those pressures are now being reflected in our data regarding compulsory hospital treatment.
“The Commission hopes that these issues, and other details emerging from this report, will be considered by the government as they take forward the reform of Scotland’s Mental Health Act.”
The Commission is also concerned at the way emergency detention takes place in some parts of the country. Detentions are supposed to take place with the consent of a specialist social worker, called a mental health officer. The rates where this happens vary greatly, with 83% compliance in Dumfries and Galloway and only 33% compliance in Greater Glasgow and Clyde.
Dr Connolly added: “The consent of a mental health officer in these cases is an important safeguard for the individual. The low rates in some areas are a real concern for us and we hope that our data will be taken into account by the government and by health boards, local authorities and integrated joint boards, with whom we will continue to raise it.”
The Commission is interested in how the Act is applied to people from different ethnic backgrounds within the population. Four per cent of Scotland’s population is minority ethnic. From the monitoring forms returned to the Commission in the last year, 5.8% of detention certificates related to people from ethnic minorities.
The report can be found here.
There are three forms of detention. Emergency detention certificates are used for crisis care and last up to 72 hours. Short term detention certificates lasts up to 28 days. Compulsory treatment orders can last initially up to six months.
Each form of detention has different requirements related to who has responsibility for issuing a detention.
Mental health charity Penumbra has reacted to the “worrying” findings of a report published by the Mental Health Commission for Scotland on the increase in the use of compulsory treatment.
The Mental Welfare Commission’s report has revealed that 6,038 new episodes of compulsory treatment using the Mental Health Act in Scotland last year – the highest figure since the Act came into force in 2003.
The new data also shows rising figures for young people aged under 25 being given compulsory treatment. The female age group with the highest rate of emergency detention certificates per 100,000 population was young women aged 18 to 24, totalling 185 certificates in the year.
This compares with 105 for the same age group in 2009/10. Young men age 16 to 17 have seen the greatest increase in rates of emergency detention per 100,000 population in the past year, and both young men and women aged 16 to 17 have shown the greatest increase in the rate of emergency detention across the 10 year period observed.
There has also been a rise in the number of short term detention certificates used in relation to young people. In women under the age of 25, there has been a 122.5% increase in the use of short term detention since 2009/10, rising from 142 to in 2009/10 to 316 in 2018/19.
Nigel Henderson, Chief Executive of mental health charity, Penumbra, said: “Whilst compulsory treatment may not always be avoidable, it should not be inevitable.
“However, these figures show a worrying rise in the use of compulsory treatment. For young people in particular, the figures are a stark reminder that there is a gap in mental health support services for this age group. People need the right support at the right time.
“The report also highlights concerning issues around compliance. It should not be the case that large numbers of compulsory treatment orders are being applied without the consent of a specialist social worker or Mental Health Officer. However, in one local authority area only 33% compliance was met.
“It will be important for the forthcoming review of the Mental Health Act to consider these findings carefully, but I would also urge councils and health boards to look at how they’re using compulsory treatment.”
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