Public Expenditure on Health and Personal Social Services 2009 - Health Committee Contents


5.  ACTIVITY AND PERFORMANCE

5.1.19  How many patients with (a) mental illness and (b) learning difficulties have been resident in each high secure hospital in each year from 1997? Can the Department comment on numbers and prevalence in medium secure hospitals and prisons? (Q58)

Answer

  1.  Tables 58a and 58b show the total number of patients in high security psychiatric hospitals in each of the last 10 years, from 1997 to 2008, and the number of patients who were classified as having a learning disability (within the Mental Health Act 1983 categories of mental impairment or severe mental impairment) for the same period. The figures embrace mental illness, psychopathic disorder, mental impairment and severe mental impairment. The learning disabilities figures in table 58b are also included in table 58a and embrace the Mental Health Act 1983 classifications of mental impairment and severe mental impairment.

2.  Table 58a indicates a continuing downward trend in the total number of high security psychiatric hospital patients and in the number of patients with a classification of mental impairment/severe mental impairment. Figures exclude patients on trial leave of absence and dangerous and severe personality disorder patients.

3.  The downward trend demonstrated in the table reflects the development in recent years for the high security psychiatric hospital patient population to reduce as secure psychiatric services more widely, particularly at a medium secure level, have been developed.

Medium secure services

  4.  Data are not available for the total number of people with mental illness and with learning disabilities who have been in medium secure psychiatric units. However table 58a shows the figures that are available for the numbers of patients in NHS secure units—these figures include patients in high, medium and low secure units. The figures do not include NHS patients in independent sector units. There are currently 66 medium secure units, with just over one-third being run by the independent sector.

Prevalence of mental illness and learning difficulties in the prison population

  5.  It is not possible to state with any precision how many prisoners have mental illness at any one time. However, a survey of mental ill health in the prison population undertaken in 1997 by the Office for National Statistics[9] estimated that around 90% of prisoners had at least one of the five disorders (personality disorder, psychosis, neurosis, alcohol misuse, and drug dependence) considered in the survey. Co-morbidity levels are also high.

6.  More recently, Ministry of Justice research suggested that common mental health problems are very prevalent in prisons, eg 82% of prisoners on sentences of less than four years identified with anxiety or depression[10] and an evaluation of prison mental health in-reach services found up to 25% of prisoners are affected by more serious mental health conditions.[11]

  7.  The number of prisoners transferred to hospital under the Mental Health Act 1983 was 1,278 in 2008-09. This figure has remained relatively stable over the last three years.

  8.  There is currently no routine screening for learning disabilities in prisoners. However recent research among adult male prisoners in the north west showed that the rate of learning disabilities was 7%, compared to a rate of 2% in the general population.



Table 58a

TOTAL NUMBER OF PATIENTS RESIDENT IN HIGH SECURE HOSPITALS


As at
Ashworth
Broadmoor
Rampton
Total

31.12.97
456
440
454
1,350
31.12.98
426
426
457
1,309
31.12.99
416
429
447
1,292
31.12.00
410
410
429
1,249
31.12.01
405
382
392
1,179
31.12.02
367
331
375
1,073
31.12.03
289
314
372
975
31.12.04
270
286
357
913
31.12.05
272
272
360
904
31.12.06
237
286
339
862
31.12.07
216
250
325
791
31.12.08
213
253
312
778

Source:
High Security Hospital Specialised Commissioners
  
Footnotes:
1.  The figures embrace mental illness, psychopathic disorder, mental impairment and severe mental impairment.


Table 58b

TOTAL NUMBER OF PATIENTS WITH LEARNING DISABILITIES IN HIGH SECURE HOSPITALS


As at
Ashworth
Broadmoor
Rampton
Total

31.12.97
18
0
111
129
31.12.98
9
0
104
113
31.12.99
0
0
95
95
31.12.00
3
0
87
90
31.12.01
3
0
87
90
31.12.02
4
1
75
80
31.12.03
2
0
63
65
31.12.04
0
0
55
55
31.12.05
0
0
48
48
31.12.06
0
0
40
40
31.12.07
0
0
44
44
31.12.08
0
0
39
39

Source:
High Security Hospital Specialised Commissioners
  
Footnotes:
1.  These figures are included in the first part of the table—embracing the Mental Health Act 1983 classifications of mental impairment and severe mental impairment.





9   Psychiatric morbidity Among Prisoners in England and Wales, ONS 1998. Back

10   Stewart D The problems and needs of newly sentenced prisoners MoJ research series 2008. Back

11   Shaw et al (2008) A National evaluation of prison mental health in reach services. Back


 
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