Wide regional variation in numbers of Guardianship cases
The number of new Guardianship cases under the Mental Health Act rose by four per cent in England in 2013-14, according to a new Health and Social Care Information Centre (HSCIC) report.
Such cases totalled 290, a rise from 280 cases in 2012-13. This is the first rise in the number of new cases since 2009-10 (when 440 new cases were recorded).
The number of continuing cases2 was 600 at the end of March 2014, a decrease of four per cent from 2013-14. This is the ninth consecutive year of decline.
Guardianship3 allows a local social services authority or named individual to take certain decisions on behalf of a person with a mental disorder being cared for in the community, to protect their welfare or the welfare of others. Decisions might include where the person lives, or appointments they need to attend.
Today’s report, Guardianship under the Mental Health Act, 1983, England, 2013-14 points to wide variations in the number of Guardianship cases across regions4, with 30 of 152 Local Authorities having no cases to report for this period. The report shows:
- The North East had the highest number of new cases relative to its population, with 10.8 cases per million of the population, an increase from 8.1 cases per million population in 2012-13. This is double the England rate of 5.3 per million of the population.
- The Eastern region had the fewest new cases relative to its population, with 1.8 cases per million of the population.
- The North West had the highest number of new cases (64), accounting for 22 per cent of all the new cases in England.
- The North West also had the highest rate of continuing cases, both in terms of the actual number of cases and rate of cases per million of the population. There were 160 continuing cases, accounting for 26 per cent of the total for England, giving a rate of 22.0 per million of the population.
- London has the lowest rate of continuing cases, with 2.7 per million of the population.
- The median duration to closure of Guardianship cases in England was 11.9 months. The shortest duration reported was seven days and the longest was 30.3 years.
- East Midlands reported the longest median duration for closed Guardianship cases, at 28.5 months.
- London had the shortest median duration for closed Guardianship cases, at 6.0 months
Whilst the total number of Guardianship cases is demonstrating an ongoing decline, the number of patients cared for under other Mental Health legislation is increasing. Community Treatment Orders (CTOs) aim to promote the welfare of people who would otherwise be detained in hospital and Deprivation of Liberty Safeguards (DoLS)5 protect people who lack the capacity to make decisions about their own care or treatment and to ensure that they are only deprived of their liberty in a necessary and proportionate way. CTO cases increased by 13 per cent between 2009-10 and 2012-13, from 4100 to 4600 cases. The number of granted DoL applications nearly doubled in the same period (from 3300 to 6500 applications granted.)
Kingsley Manning, Chair of the Health and Social Care Information Centre said: “The number of Guardianship cases is generally declining and this may be because there is now alternative Mental Health legislation to care for patients with a mental health disorder who are a risk to themselves or others.
“Although we cannot state a direct cause and effect, the use of Deprivation of Liberty Safeguards (DoLS) and Community Treatment Orders (CTOs) has increased as the number of Guardianship cases has decreased. This could indicate that the changes to legislation have led to changes in local practice.”