Statistical Publication Notice

27 July 2010

Click here for Mental Health (Psychiatric) Hospital Activity Statistics

Introduction

Individuals with a mental health problem may have contact with the National Health Service in Scotland in a variety of different settings including: consultation with their General Practitioner; with a member of a specialist community mental health team; at a hospital outpatient clinic; as day patients in a day hospital or day unit; or as an inpatient in hospital.

In recent years, strategies for the provision of mental healthcare services have changed the emphasis from hospital based inpatient care to outpatient, day patient and community based care.  Nevertheless, inpatient treatment comprises a significant proportion of the mental health services provided in Scotland, particularly for the more severe cases and those requiring admission under the Mental Heath Act.

This release summarises activity statistics for mental health hospitals in Scotland including inpatient, day patient and outpatient data up to and including the year ending 31st March 2009.

Key Points

• There were around 22,980 inpatient admissions to mental health hospitals during the year ending 31 March 2009. This continues the downward trend seen in recent years and represents a 19% fall in the number of admissions since 2004.
• In 2008/09 around 57% of all inpatient mental health admissions were re-admissions. This percentage is similar to those of the previous five years.
• The number of patients who had a psychiatric readmission (within one year of a previous psychiatric admission) has decreased steadily between the years ending 31 December 2004 and 31 March 2008, from over 4,500 to around 3,700. The year on year reduction from the baseline figure at 31 December 2004 was 8.2% at March 2006, 16.3% at March 2007 and 18.6% at March 2008.  It should be noted that data for the year ending 31 March 2008 may be incomplete and are subject to change in future releases.
• Alcohol/drug related problems were responsible for 25% of all discharge diagnoses in men and schizophrenia accounted for a further 20%.  For women, mood (affective) disorders accounted for 32% of the diagnoses recorded, while dementia diagnoses were identified in 14% of discharges.
• In 2008/09, around 66% of all mental health discharges had a hospital length of stay of 4 weeks or less.

Interpretation

Mental health activity data is collected across NHSScotland and is based on nationally available information routinely drawn from hospital administrative systems across the country.  The principal data source is the SMR04 (mental health) return, which collects information on admissions to and discharges from NHS psychiatric hospitals in Scotland.

Over recent years, significant improvements have been made with regard to the level of SMR04 data completeness and it is estimated that nationally 99% of all data returns for 2008/09 have been made. The shortfall is largely due to data returns from NHS Fife which are currently estimated to be around 90% complete.  Further information on SMR data completeness is shown at http://www.isdscotland.org/isd/1607.html

It is important to be aware that the ongoing efforts to improve the quality of SMR04 data, may result in differences to previously published figures. Information contained in future releases may also be subject to change.

Detailed Findings

• Of the 22,983 inpatient admissions in the year ending 31 March 2009, 57% were for patients who had experienced a previous spell of psychiatric inpatient care, 31% were for patients with a first ever admission to psychiatric inpatient care, 8% were transfers from another mental health hospital and for 3.5% the admission type is not known.
• There has been a steady reduction in female first admissions since the 1980s.  First admissions amongst men have remained relatively stable in recent years. In 2008/09 the number of first admissions for both males and females has increased slightly compared to the previous year.
• Whilst the number of patients who had a psychiatric readmission (within one year of a previous psychiatric admission) has reduced by around 19% across Scotland between the years ending 31 December 2004 and 31 March 2008, there are variations at NHS Board level. NHS Highland, NHS Fife and NHS Lothian show decreases of over 25% while other boards have reported an increase over the same time period.  It should be noted that data for the year ending 31 March 2008 may be incomplete and are subject to change in future releases. Similarly Information for the year ending 31 March 2009 is not yet available due to incomplete data.
• Significantly more males than females discharged from psychiatric hospitals have a diagnosis of alcohol/drug related problems (25% compared with 12%) or schizophrenia (20% compared to 8%). Conversely a higher proportion of females than males have a diagnosis of mood (affective) disorders (32% compared to 20%).
• Schizophrenia was most common reason for readmission amongst males accounting for 28% of all male readmissions. Mood (affective) disorders was the most common reason for readmission in females amounting to 35% of all female readmissions.
• The length of stay within mental health hospitals varies with age, reflecting the different nature of the illnesses being treated.  In 2008/09, for patients aged 25-44, three quarters of discharges had a hospital stay of 4 weeks or less.  Whereas over 70% of discharges for older patients (aged over 75), who may be suffering from chronic or degenerative illnesses such as dementia, had a hospital stay of more than 4 weeks.
• In the year ending 31 March 2009, just over 1.4 million new outpatients were seen in Scotland. The total seen in psychiatric specialties (51,024) accounts for just over 3.6% of all new outpatient appointments. Around 1 in 6 of new outpatients at psychiatric specialties failed to attend an appointment. This compares with 1 in 10 for all new outpatient appointments.
• The proportion of formal admissions has remained around 14% of total admission over the past five years. However, the overall number of formal admissions has followed the downward trend in total admissions.

Main Contacts

Emma McNair
Principal Information Analyst
0131 275 6668
emma.mcnair@nhs.net

Gordon Thomson
Senior Information Analyst
0131 275 6844
gordond.thomson@nhs.net

Colin Houston
Information Analyst
0131 275 6397
colin.houston@nhs.net

Glossary

SMR04 – Scottish Morbidity Record 04 – records information on all inpatient admissions and discharges from NHS mental health (psychiatric) hospitals in Scotland.

Formal Admission, Formal detention – Admission to psychiatric inpatient facilities under the jurisdiction of the Mental Health (Scotland) Acts 1960 & 1984 and the Mental Health (Care and Treatment) (Scotland) Act 2003.

Forensic Psychiatry – A specialised branch of clinical psychiatry which relates to mentally disordered offenders and others with similar problems.

Pre-Release Access

Under terms of the "Pre-Release Access to Official Statistics (Scotland) Order 2008", ISD are obliged to publish information on those receiving Pre-Release Access ("Pre-Release Access" refers to statistics in their final form prior to publication). The standard maximum Pre-Release Access is five working days. Shown below are details of those receiving standard Pre-Release Access and, separately, those receiving extended Pre-Release Access.

Standard Pre-Release Access

Scottish Government Health Department (Analytical Services Division)
NHS Board Chief Executives
NHS Board Communication leads

Extended Pre-Release Access

Scottish Government Health Department (Analytical Services Division)
This extended Pre-Release Access is given to a small number of named individuals in the Scottish Government Health Department (Analytical Services Division). This Pre-Release Access is for the sole purpose of enabling that department to gain an understanding of the statistics prior to briefing others in Scottish Government (during the period of standard Pre-Release Access).

History of this Publication

Last Published: 28 July 2009
Next Due: July 2011
Data Available Since: Web publication from 2003. data available form 1982