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Scottish Community Care Statistics 2002

CHAPTER 3 - ADULTS WITH MENTAL HEALTH PROBLEMS

The Balance of Care

Chart 3.1 illustrates the balance of care provided to people with mental health problems over time. The number of occupied beds in hospitals has more than halved between 1980 and 2002. Over the same period, the number of residents in residential care homes has increased almost seven-fold. Despite this change of direction, hospitals still dominate the balance of care for this client group; there are more than 5 times more occupied beds in hospitals than there are residents in residential care homes.

The number of people attending day centres has also increased significantly since 1985. Data on home care clients and residents in nursing homes with mental health problems have not been collected for long enough to allow comment on any trends.

Chart 3.1 Balance of Care for People with Mental Health Problems, 1980-2002

Domiciliary Care

Tables 3.1 and 3.2 contain information on home care services provided to clients with mental health problems. Information on home care for other individual client groups is included in chapters 1, 2, 4 and 5. More detailed analysis of home care for all client groups is contained in chapter 1. Please refer to the notes in annex A for definitions on which the data are collected.

Table 3.1: Age Breakdown of Clients with Mental Health Problems Receiving Home Care, 1998-2002

Source: SEHD Community Care Statistics - H1 Return

Table 3.1 presents the age breakdown of people with mental health problems receiving home care from 1998 to 2002. Prior to 1998 a full age/client group breakdown was not provided.

There was an increase of 7.2 per cent in the number of people with mental health problems receiving home care between 2001 and 2002 (2,222 clients in 2002). 53 per cent of all clients receiving home care were aged between 18 and 64.

Table 3.2: Age Breakdown of People with Mental Health Problems Receiving Home Care, 2002

Source: SEHD Community Care Statistics - H1 Return

Table 3.2 shows the age breakdown of clients with mental health problems receiving home care services within each local authority in 2002.

Orkney Islands had the highest number of clients (32.1) with mental health problems receiving home care per 10,000 of the population aged between 16 and 64. Conversely, East Dunbartonshire had the lowest rates in Scotland with 2.0 clients per 10,000 of the population aged 16-64.

The Scotland rate per 10,000 of the population aged 16-64 receiving home care amounted to 6.8.

Day Care

Tables 3.3 and 3.4 provide information on day care services primarily intended for people with mental health problems. Day care figures for other client groups are included in chapters 1, 2, 4 and 5. Please refer to the notes in annex A for definitions on which the data are collected.

In 1998 a new methodology was introduced for dealing with non-response. Care should be taken when comparing time series data before and after 1998 as the figures may not be directly comparable. Please refer to annex A for more details.

In 2001, a new survey of day care services took place. The figures for "number attending" in 2001 are not comparable with previous years. In 2001, information was collected on numbers attending day centres during the census week. In previous years, the numbers attending related to all persons who regularly attended regardless of whether they were there during census week.

Table 3.3: Number of Day Centres ¹ for People with Mental Health Problems, Places and People Attending, 1985-2002

¹ Includes centres with four places or less (which are usually attached to residential homes).
² No Day Care Survey took place in 1999 and 2000.
Source: SEHD Community Care Statistics - D1-B Return

Table 3.3 shows the number of day centres, places and attendees for people with mental health problems, from 1985 to 2002.

The number of centres, places and attendees steadily increased until 1997 when it peaked with 572 places and 963 people attending.

In 2002, there were 525 places and 512 people attending; and average of 28 places and 27 people per centre.

Table 3.4: Day Centres ¹ for People with Mental Health Problems as at 31 March 2002

¹ Includes centres with 4 or less places (which are usually attached to residential homes).
Source: SEHD Community Care Statistics - D1-B Return

Table 3.4 presents the number of day centres, places and attendees for people with mental health problems in each local authority in 2002. Only 10 local authorities reported day centre provision primarily intended for people with mental health problems.

Midlothian provided the highest number of places (14.5) per 10,000 of the population aged between 16 and 64, and Eileanan Siar provided the highest number of attendees (26.1) per 10,000 of that age group. The Scotland rate for both number of places and number attending was 1.6 per 10,000 of the population aged 16-64.

Residential Care Homes

Tables 3.5 to 3.12 contain information on residential care homes primarily intended for people with mental health problems. Homes for other client groups are included in chapters 1, 2, 4 and 5. Please refer to the notes in annex A for definitions on which the data are collected.

In 1998 a new methodology was introduced for dealing with non-response. Care should be taken when comparing time series data before and after 1998 as the figures may not be directly comparable. Please refer to annex A for more details.

Table 3.5: Residential Care Homes for People with Mental Health Problems, 1980-2002

¹ In 1980 the figures for the private and voluntary sectors are grouped together.
Source: SEHD Community Care Statistics - R1 Return

Table 3.5 shows the number of residential care homes, beds and residents for people with mental health problems in each sector from 1980 to 2002.

After a sharp rise in the number of beds in the period 1980 to 1998 the growth has since levelled off, in 2002 there were 1,346 beds available. Since 1990, a large majority of residential care beds have been within the voluntary sector. Since 1995, the proportion of beds in the local authority sector decreased from 5 per cent to
2 per cent.

In 2002, 85 per cent of residents were in voluntary run homes, 13 per cent in privately run homes and 2 per cent were in homes run by the local authority.

Table 3.6 shows a local authority split of the number of residential care homes, residents and beds, for people with mental health problems, at 31 March 2002.

In Scotland there were 184 homes with on average 7 places per home and 6 residents per home.

There were 3.6 residents in care homes for people with mental health problems for every 10,000 of the population aged between 16 and 64. However, in Aberdeen City this figure was 9.8, whilst East Dunbartonshire had 0.6 residents per 10,000 of the population aged 16-64. Five local authorities had no homes primarily intended for people with mental health problems.

Table 3.6: Residential Care Homes for People with Mental Health Problems, 31 March 2002

Source: SEHD Community Care Statistics - R1 Return

Table 3.7 presents information on the number of admissions to and discharges from residential care homes for people with mental health problems.

Long stay admissions accounted for the majority of admissions until recent years. The number of short stay admissions has increased over time and now represents the majority. In 2002, 57 per cent of all admissions and 56 per cent of all discharges were short stay. Please refer to annex A for a definition of short stay.

Within the local authority sector, from 1995 onwards, almost all admissions and discharges were long stay. In 2002, within the private and voluntary sector the majority of admissions and discharges were for short stay clients (59 per cent).

Table 3.7: Admissions and Discharges in Residential Care Homes for People with Mental Health Problems, 1985-2002

¹ Totals may not equal the sum of their component parts due to the effects of rounding.
Source: SEHD Community Care Statistics - R1 Return

Table 3.8: Age of Residents ^1,2 in Homes for People with Mental Health Problems, 1985-2002

¹ Total residents relates to long stay residents only.
² Percentages are based on the number of residents whose age is known.
Source: SEHD Community Care Statistics - R1 Return

Table 3.8 provides an age breakdown of residents in homes for people with mental health problems from 1985 to 2002.

The age breakdown of residents has remained fairly steady between 1985 and 2002 with only a slight decreases in the under 30s age group, which dropped to 11 per cent in 2002. The majority of residents (72 per cent of residents in 2002) are aged between 31 and 65.

Table 3.9: Incomplete Length of Stay of Residents ^1,2 in Homes for People with Mental Health Problems, as at 31 March, 1985-2002

¹ Total residents relates to long stay residents only.
² Percentages are based on the number of residents whose length of stay is known.
Source: SEHD Community Care Statistics - R1 Return

Table 3.9 illustrates the length of stay of residents in residential care homes for people with mental health problems from 1985 to 2002.

Between 1990 and 1998 the largest group of residents stayed for between 1 and 3 years (around 28 per cent). Since then however, a higher proportion of residents had stayed for 5 years or more, 38 per cent in 2002.

Table 3.10: Destination of Residents ^1,2 on Discharge from Homes for People with Mental Health Problems, 1990-2002

¹ Total residents relates to long stay residents only.
² Percentages are based on the number of residents where destination on discharge is known.
Source: SEHD Community Care Statistics - R1 Return

Table 3.10 presents an overview of the destination of residents on discharge from homes for people with mental health problems.

In recent years the number of residents discharged to their own home and transferred to another home have dominated, whilst the proportion discharged to sheltered housing has remained very low. In 1999 the number
of residents discharged to their own homes fell quite markedly, in 2002 this increased to pre 1999 levels
(36 per cent).

Table 3.11: Financial Support of Residents ^1,2 in Private and Voluntary Homes for People with Mental Health Problems, 2002

¹ Total residents relates to long stay residents only.
² Percentages are based on the number of residents where financial support was known.
Source: SEHD Community Care Statistics - R1 Return

Table 3.11 details the funding arrangements for residents in residential care homes for people with mental health problems. For definitions of categories of funding see annex A.

The majority of people (78 per cent) are funded by local authorities. Only 2 per cent of residents were supported privately whereas 19 per cent were supported mainly by the DSS.

Table 3.12: Average Weekly Charge per Resident in Homes for People with Mental Health Problems, 2002

Source: SEHD Community Care Statistics - R1 Return

Table 3.12 presents the average weekly cost of residential care for each sector in 2002. The figures have been weighted to reflect the capacity of the residential homes.

The average weekly charge for Scotland was 375 per week in 2002. However, in Local Authority homes the cost is 412 per week.

Private Nursing Homes

Up to the year ending March 2002, information has not been available on which nursing homes were registered for residents with mental health problems. However information has been collected on the number of residents in private nursing homes with mental health problems, and these are described here.

Table 3.13: Private Nursing Homes; Residents with Mental Health Problems ¹; percentage by Age Group: as at 31 March 1997-2002

¹ Private Nursing Homes subject to the Nursing Homes Registration (Scotland) Act 1938 (as amended), or the Mental Health Act 1960/1984. The data include hospices registered under the Act, but data for private hospitals have been excluded.
^r Data are based on information supplied by nursing homes at the end of each financial year. However, since the previous publication, figures have been revised from year ending 31 March 1997 onwards: quality assurance work has been undertaken, and additionally, for each home which did not supply data, figures have been imputed, using data for those years which were available. The number of homes which did not supply data and for which figures have been imputed are as follows: 1997: 29 homes; 1998: 31 homes; 1999: 49 homes; 2000: 52 homes; 2001: 75 homes; 2002: 65 homes. In addition a small number of records have been modified or deleted.
Note that information has not been available to impute missing data prior to year ending March 1997, nor is it known how many homes failed to submit data at that time. This may result in discontinuities in the figures.
Source: ISD Scotland - ISD(S)34 Return

Table 3.13 shows, for residents in private nursing homes with mental health problems, the trend from year ending March 1997 to year ending March 2002 in numbers and in percentages by age group.

The total number of residents with mental health problems in private nursing homes decreased until 1999 and since then has increased. In March 2002 there were 876 residents with mental health problems. Over the period surveyed there has been an increase in the proportion of residents in the 18-64 age group, and a decrease in the proportion in the 75-84 age group.

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