Mental Welfare Commission for Scotland, Edinburgh, Scotland.
Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.
Soc Psychiatry Psychiatr Epidemiol. 2023 Sep;58(9):1343-1352. doi: 10.1007/s00127-023-02459-3. Epub 2023 Mar 30.
The Mental Health Act in Scotland is under review. Previous iterations increased patients' rights but the maximum time for short-term detentions remains unchanged, despite evolving psychiatric treatment models. We explored length, mode of ending and factors of influence on the application of short-term detention certificates (STDCs), which can last up to 28 days, across Scotland between 2006 and 2018.
Data on age, gender, ethnicity, date of commencement and ending of the STDC and detention site from all 42,493 STDCs issued to 30,464 patients over 12 years were extracted from the national repository for detentions under the Mental Health (Care and Treatment) (Scotland) Act 2003 and analysed using mixed models.
One in five STDCs lapsed on day 28. Two in five were revoked and the remainder extended to a treatment order. STDCs that were not extended averaged 19 days, and revoked STDCs 14 days. The probability of a detention lapsing varied across hospitals and increased with patient age. The odds of a detention lapsing on day 28 were 62% lower and revoked detentions 10% shorter in 2018 relative to 2006. The odds of a detention extending decreased significantly from 2012 to 2018. Extended STDCs were associated with increased patient age, male gender, and ethnicity other than White Scottish. There was little initiation of or active revocation of STDCs on weekend days.
The length of STDCs reduced over time, fewer detentions lapsed, and weekday patterning was evident in each year. These data can inform legislative and service reviews.
苏格兰的《精神健康法案》正在修订中。尽管精神科治疗模式不断发展，但之前的修订增加了患者的权利，但短期拘留的最长时间仍保持不变。我们探讨了 2006 年至 2018 年期间苏格兰所有 42493 份短期拘留证（STDC）中，拘留时间、结束方式以及影响短期拘留证申请的因素，每份 STDC 的最长拘留时间为 28 天。
从 2003 年《精神健康（护理和治疗）（苏格兰）法案》规定的全国拘留档案库中提取了过去 12 年中为 30464 名患者签发的所有 42493 份 STDC 的年龄、性别、种族、开始和结束日期以及拘留地点的数据，并使用混合模型进行分析。
五分之一的 STDC 在第 28 天失效。五分之二被撤销，其余的则延长至治疗令。未延长的 STDC 平均拘留 19 天，被撤销的 STDC 拘留 14 天。拘留失效的可能性因医院而异，并随患者年龄的增加而增加。与 2006 年相比，2018 年 28 天拘留失效的可能性降低了 62%，被撤销的拘留减少了 10%。从 2012 年到 2018 年，拘留延长的可能性显著下降。延长的 STDC 与患者年龄较大、男性和非白苏格兰族裔有关。周末很少有 STDC 的开始或主动撤销。
随着时间的推移，STDC 的拘留时间缩短，失效的拘留减少，并且每年都有明显的工作日模式。这些数据可以为立法和服务审查提供信息。
