percentage
1994/95	18.7
1995/95	19.2
1996/97	19.2
1997/98	21.2
1998/99	23.1
1999/00	23.3
2000/01	25.2
2001/02	25.0
2002/03**	27.5
2003/04**	27.0

*HES refers to Hospital Episode Statistics
**Note: the number of HES admissions to psychiatric specialities for 2000/01 is provisional. Detentions after admission includes only changes from Informal to Sections 5(4), 5(2), 2 and 3 and changes from Section 136 to Sections 2 and 3.

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Circumstances of detention

Have there been any changes in the types of inpatient facilities used to detain formal patients?
Although private facilities are not often used to detain people under the Mental Health Act, the number of formal admissions to them has more than trebled in recent years: from 418 in 1990-91 to 1,403 in 2003-04.

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How do admission rates compare for different types of detention?

In 2003-04, a total of 95 per cent of all formal admissions were to NHS facilities. Of all these formal admissions to NHS facilities, 89 per cent were under Part II of the Act (Sections 2,3 and 4). The section most commonly used to detain patients was Section 2 (see chart below).

Court and prison disposals (Part III of the Mental Health Act) accounted for the remaining 5 per cent of formal admissions to NHS hospitals in 2003-04.

Formal admissions to NHS facilities (including high security hospitals) of patients detained under the Mental Health Act 1983, by legal status, 2003-04, England

Source: Department of Health, 2004.
Note: (a) Other includes Sections 34, 36,37, 38, 44, 46, 47 and 48 of the Mental Health Act 1983, Previous legislation and Other Acts, (b) Figures are approximate to one decimal place.

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Where are people likely to be detained?

At 31 March 2004, there were14,000 patients detained in all facilities, compared with 13,555 a year earlier. Of these, 11,708 were in NHS facilities and 2,292 were in private mental nursing homes.

Formal residents by category of disorder and type of facility, England, 31 March 2004

Number of patients

	All facilities	NHS Trusts	Private mental nursing homes
All categories	14,000	11,708	2,292
Mental illness	10,697	9,142	1,555
Psychopathic disorders	686	452	234
Severe/mental impairment	1092	684	408
Not specified*	1,525	1,430	95

*A category of disorder does not need to be assigned to patients under sections 2,4, 5(2), 5(4), 135 or 136

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How many people are sent to hospital under the Mental Health Act by the courts or are transferred from prison into hospital?

In recent years, court and prison disposals have risen by 7 per cent; from 1,498 in 2002-03 to 1,601 in 2003-04. This accounts for about 6 per cent of formal admissions to NHS hospitals in 2003-04.

In 2003-04, about 20 per cent (257) of Part III admissions related to orders made under Section 37 without restriction. These are cases where the court has made an order at the time of conviction rather than where a person passes from the penal system to hospital. A further 10 per cent (130) of court disposals related to patients remanded in hospital for a report (Section 35). These orders can only last for twelve weeks and are an alternative to remand to prison.

The other major group of admissions to NHS hospitals, under Part III disposals, relates to those detained with restrictions. About 50 per cent (670) of court disposals were of prisoners transferred to hospital with restrictions. Around 480 were transferred to hospital under Section 47 (after sentence) or Section 48 (not sentenced) with Section 49 restrictions. There were also 190 admissions under Section 37 with restrictions. Such patients are subject to continuous detention until such a time as they are discharged or the restriction is lifted by the Home Secretary.

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Demographic statistics

Are there any differences between the numbers of men and the numbers of women detained under the Mental Health Act?

In 1990-91, more women than men were admitted to hospital under the Act, making up a total of 51 per cent (8,908) of all formal admissions. However, by 1998-99 this was reduced to 46 per cent. The number of formal admissions for men has risen steadily over this period, largely due to a much higher rate of increase in Part II admissions for men. Over the past fifteen years, this has almost doubled from 7,072 in 1990-91 to 13,402 in 2003-04, whereas the number of women increased by less than 25 percent over the same period. The difference between men and women is particularly striking for high security psychiatric hospitals, where 1,161 males were detained compared with less than 161 females.

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Are there any regional differences in terms of the numbers of people detained under the Mental Health Act?

Yes there are. London has the highest rate at 140 people detained per 100,000 population, and the Eastern region has the lowest at 70 per 100,000.