Health and social care professionals issued just over 2,000 Community Treatment Orders (CTOs) between November 2008 and March 2009 under new powers introduced by the Mental Health Act 2007, says a report from The NHS Information Centre today.

The purpose of a CTO is to allow patients to continue their treatment in the community following discharge from hospital after a period of detention under the Mental Health Act. While on a CTO patients can, if necessary, be recalled to hospital for up to 72 hours, normally for further treatment.

CTOs were introduced in November 2008 and, for the first time, today's report includes information about their use in the national statistical bulletin about uses of the Mental Health Act. The report shows that, at 31 March 2009, 1,755 patients were still on supervised community treatment (SCT), including 22 for whom an independent facility was the responsible provider. Of those subject to SCT, 1,178 were men and 577 were women.

The report also shows that during 2008/09, 207 CTOs involved the patient being recalled to hospital and in 143 cases the CTO was ‘revoked' and the patient went back to be detained in hospital again. Of the CTOs issued, only 33 had ended with the patient being discharged from the order by 31 March 2009.

NHS Information Centre chief executive Tim Straughan said: “The report gives us an important early picture of the extent to which these new powers are being used by care professionals for the well-being of patients with severe mental health conditions.

“Capturing the first five months of implementation, the figures show that an average of roughly 100 mental health patients per week have been discharged from detention onto a community treatment order to continue their treatment in the community.

“Since, at 31 March 2009, only 33 patients had been discharged from these orders, we can expect that the numbers of patients on supervised community treatment will continue to grow.”

The report, In-patients formally detained in hospital under the Mental Health Act 1983 and patients subject to supervised community treatment: 1998-99 to 2008-09, also shows:

• Total formal admissions rose to 28,700 from 28,100 in 2007/08
• Although the total number of formal admissions to all hospitals rose, the number of formal admissions to NHS hospitals fell by one per cent. The overall rise in admissions is due to an increase in the number of formal admissions reported by independent hospitals, a rise of approximately 800 (42 per cent) to 2,800 from 1,900 in 2007-08
• At 31 March 2009, there were 12,300 patients detained in NHS facilities and 3,700 in independent hospitals
• The number of Place of Safety Orders issued by police on people they believed needed a mental health assessment in a hospital increased by 16 per cent to 8,800 from 7,500 in 2007/08. This followed an 18 per cent rise in 2007/08 and a nine per cent rise in 2006/07.
• In 2008-09, 78 per cent (6,200) of Place of Safety Orders did not result in the person being formally admitted to hospital, compared with 71 percent (4,900) in 2007-08.
• In 2008-09, formal admissions of people involved in criminal proceedings (referred to as Court and Prison Disposals) rose by 12 per cent to 2,100 from 2007-08 when there were 1,900.

Tim Straughan continued: “The report shows independent hospitals are being used to an increasing extent as the place to which mentally ill patients are sent when they are formally admitted under the Mental Health Act.

“It also points to greater use of police powers to remove a person who appears to be mentally disordered to hospital for assessment, even though in the majority of cases this does not result in formal admission to hospital.” The report is at www.ic.nhs.uk/pubs/inpatientdetmha0809

Notes to editors

1. The NHS Information Centre is England's authoritative, independent source of health and social care information. It works with more than 300 health and social care providers nationwide to provide the facts and figures that help the NHS and social services run effectively. Its role is to collect data, analyse it and convert it into useful information which helps providers improve their services and supports academics, researchers, regulators and policymakers in their work.
2. The NHS Information Centre also produces a wide range of statistical publications each year across a number of areas including: primary care, health and lifestyles, screening, hospital care, population and geography, social care and workforce and pay statistics.
3. The Mental Health Act 2007 introduced supervised community treatment (SCT). Patients detained in hospital for treatment under section 3 (and certain Part III sections) can be discharged from detention onto a community treatment order (CTO) to continue their treatment in the community. While on a CTO, they can, if necessary, be recalled to hospital for up to 72 hours, normally for further treatment. In this bulletin, this is called “SCT recall to hospital”. If they need to remain detained in hospital for more than 72 hours, their CTO can be revoked. If that happens, they go back to being detained under the section they were on before going onto the CTO (“revocation of SCT”). A discharge from SCT occurs when a patient's CTO ends without being revoked. SCT was introduced on 3 November 2008
4. The health and social care practitioners with the capacity to issue a Community Treatment Order are Responsible Clinicians and Approved Mental Health Practitioners. 5. Part X of the Act gives the police powers to remove a person who appears to be mentally disordered to a ‘place of safety' for assessment by a doctor and an approved mental health professional. The relevant Sections are:

• Section 135: warrant to search for and remove a patient to a place of safety
• Section 136: removal by police from a public place to a place of safety
• Sections 135 and 136 have a detention limit of 72 hours, and cannot be renewed. After this the person is either formally admitted to hospital, admitted as an informal patient (that is, voluntarily) or not admitted at all. This bulletin only includes information about Place of Safety orders where the Place of Safety was a hospital.

1. Section 5.4 of the 1983 Act allows a nurse to instigate a ‘six hour holding power' on an informal patient already in hospital and receiving treatment for a mental disorder. At the end the patient will either be formally detained under Section 2 or 3 of the Act, or returned to an ‘informal' inpatient status.
2. For media enquiries, please call 0845 257 6990 or email mediaenquiries@ic.nhs.uk