Mental Health & Learning Disability Inpatient Bed Census, 2014

2. Additional analysis: Patients receiving forensic services

Forensic psychiatry is a specialised branch of clinical psychiatry which relates to mentally disordered offenders and others with similar problems. For the purpose of the analysis contained in this section, forensic patients were identified if NHS Boards indicated 'yes' to the following census question: is the patient being managed primarily by forensic services?

507 patients were primarily managed by Forensic Services in the October census.

It should be noted that NHS Greater Glasgow & Clyde, NHS Lothian and NHS Tayside contain Forensics Regional Units which provide services to patients from other NHS Boards. NHS Fife also provide a low secure Learning Disability (Forensic) Regional Unit for the treatment of patients from other NHS boards. The State Hospital (a Special NHS Board), provides a National Service (including for Northern Ireland).

NHS Board of Treatment	Number of Patients
NHS Ayrshire & Arran	*
NHS Borders	0
NHS Dumfries & Galloway	0
NHS Fife	31
NHS Forth Valley	20
NHS Grampian	42
NHS Greater Glasgow & Clyde	128
NHS Highland	*
NHS Lanarkshire	19
NHS Lothian	65
NHS Tayside	65
NHS Western Isles	0
State Hospital	121
Scotland	507

*suppressed due to small numbers

Age and Gender

The following chart shows that the large majority of patients receiving forensic services are working age males:

Patients receiving Forensic Services, by age and gender

• 93% (471) of all patients receiving Forensic Servics were male at the October census.
• There were 36 female patients receiving Forensic Services. These were all aged between 18 and 64.
• There were 16 males aged 65 and over receiving Forensic Services.
• There is no specialist 'older adult forensic' or 'older adult learning disability forensic' inpatient provision in Scotland, so those patients whose needs are better met on older adult wards transfer there and then come under the care of older adult services (even if forensic services continue to liaise).

Ward Type

The following chart shows the number of patients receiving Forensic Services by ward type:

Patients receiving Forensic Service, by type of ward

• Just under three quarters (365, 72%) of patients receiving Forensic Services were in a Forensic ward.
• Around one in eight (62, 12%) were in a Low Secure Unit.
• Around one in twenty (25, 5%) were in a Learning Disability Unit.

As part of the review of the first census, the options under 'ward type' will be reviewed to try and remove 'ward security level' terminology in order to avoid any confusion when comparing 'ward type' with 'ward security level'.

Ward Security Level

The following chart shows the number of patients receiving Forensic Services, by the security level of their ward:

Patients receiving Forensic Services, by ward security level

• Around one in three patients receiving Forensic Services were in a Low Security ward.
• Medium Security and High Security wards each accounted for around one in four forensic patients, and combined accounted for half.
• 6% of Forensic patients were in a General Psychiatric Ward. This compares with 80% of all mental health, addiction or learning disability patients.

Specialty of Consultant

Forensic psychiatry is one of several consultant specialties which oversee the care and treatment of forensic patients.

Patients receiving Forensic Services - specialty of consultant

Excludes 20 patients in Forensic Services with missing specialty of consultant data.

• Just over three quarters (389, 77%) of patients receiving Forensic Services were seen by a specialist Forensic Psychiatrist.
• 67 patients (13% of all receiving Forensic Services) were seen by a consultant whose specialty was Learning Disabilities.

Length of stay in hospital

The tables below show that patients receiving Forensic Services are more likely to stay in hospital for a longer period of time than other mental health, addiction and learning disability patients:

Days since admission	Patients
Less than 2 weeks	13
At least 2 weeks, less than 1 month	10
At least 1 month, less than 3 months	37
At least 3 months, less than 6 months	36
At least 6 months, less than 1 year	57
At least 1 year, less than 5 years	221
5 years or more	133
Group	Average (median) number of days since admission	Approx. number of years / months
Patients receiving Forensic Services	743	2 years, 0 months
Other Mental Health, Addiction and Learning Disability patients	124	4 months

• More than two thirds (354, 70%) of patients receiving Forensic Services had been in hospital for more than a year.
• The average (median) time since admission at the census for patients receiving Forensic Services was around 2 years.
• Length of stay for patients receiving Forensic Services will be influenced by the fact that around 50% of them are in a Medium Security or a High Security ward.
• This compares with the average time since admission of just over 4 months for other mental health, addiction and learning disability patients (i.e. those who don't receive Forensic Services).