Hi again Bryan
Thanks for understanding that a precise answer to your question as
asked wasn't possible. Sorry to make you wait!
===============
FACTS & FIGURES
===============
The Department of Health (DOH) collects data from all over England and
publishes some information. The latest figures on mental health beds
only go up to 2000-2001.
1994-95 1995-96 1996-97 1997-98 1998-99 1999-00
2000-01
NHS residential
facilities - 1,160 1,280 1,280 1,360 1,300
1,280
Staffed residential
home places
for adults 22,180 24,030 34,250 35,370 35,780 37,790
37,780
This looks like an increase until you study the whole table which
shows that there has simply been a shift from long stay provision in
big hospitals etc. into smaller homes. Overall the trend is for fewer
non-acute, non-secure mental health beds. For instance:
1994-95 1995-96 1996-97 1997-98 1998-99
1999-00 2000-01
Overall NHS beds 41,830 39,480 38,780 37,880 37,060 35,740
35,490
long stay for elderly 10,760 9,330 8,230 7,410 6,990 6,040
5,540
long stay other ages 7,830 6,730 5,410 4,910 4,710 4,310
4,200
You can see the whole table here:
"Hospital beds & places in residential & nursing care homes for people
with mental illness"
http://www.doh.gov.uk/HPSSS/TBL_B23.HTM
------
Because the DOH oversees the registration of private homes, they
publish more information on these than on local authority homes.
In a report called "Community Care Statistics 2001: Private Nursing
Homes, Hospitals and Clinics", they tell us:
"At 31 March 2001, there were around 5,700 private nursing homes,
hospitals and clinics, a fall of 3% compared with 2000 – continuing
the downward trend seen since 1998.· Compared with 2000, the number of
general nursing and mental nursing homes has fallen by 4% and 3%
respectively. Only in private hospitals and clinics was there an
increase of around 20.
Over the last five years, the proportion of general nursing homes has
decreased from 79% to 73%. There has been a corresponding increase in
the proportion of mental nursing homes from 15% to 18%.
81% of registered beds in homes were occupied (this figure was 80% in
2000), with some variation by type of accommodation – rates of 83%,
79%, 62% in general nursing homes, mental nursing homes, private
hospitals and clinics respectively."
This report covers beds for mental health patients in general nursing
homes as well as specialist mental health homes.
East Sussex is covered by the broad category 'South Thames' in the
report.
Community Care Statistics 2001
http://www.doh.gov.uk/public/sb0209/sb0209.pdf
-------
The Centre for Public Mental Health at Durham University has been
'mapping' mental health provision and produced a document called
"Mental Health Service Provision for Working Age Adults in England
2001", which obviously excludes provision for the elderly.
Mental Health Service Provision for Working Age Adults in England 2001
http://www.dur.ac.uk/service.mapping/atlas_2001_02.pdf
East Sussex had 22 residential care homes, with England as a whole
having 1329. (Table 18A)
You can find a lot of detail about local care by clicking on 'East
Sussex' in the table, or I hope this direct link will work:
Details for LIT East Sussex
http://www.dur.ac.uk/gyles.glover/local/MaptestAtlasQueries2.php?stage=stage2&servtype=48~50~51~53~53~54&litnum=23
-------
Adding things up, there seem to be fewer than 400 beds, in homes not
hospitals, for working age adults in the whole of East Sussex.
Since the Community Care Statistics report gives 669 as the number of
private mental health beds in homes in East Sussex and since there is
virtually no local authority provision in the area (see next section),
this suggests fewer than 300 beds for the elderly with mental health
problems.
However, these figures may not be entirely accurate as we may not be
comparing like with like. One report's definition of a mental health
bed in a home may not be exactly the same as another's.
It is hard to believe there are no official estimates about how many
people are in need of ongoing residential care for mental health
reasons, but I found nothing except figures for those detained
compulsorily in psychiatric hospitals. Perhaps one could use the
Community Care report's figure of about 80% bed occupancy combined
with the DOH "Hospital Beds and Places in ...Homes" data to form some
kind of estimate.
---------
Home page for Centre for Public Mental Health
http://www.dur.ac.uk/mental.health/
========
PLANNING
========
All mental health planning in England is meant to be guided by a
Department of Health document (which, by the way, has a helpful
glossary for all the jargon and acronyms):
The National Service Framework for Mental Health (pub NHS 1999)
http://www.doh.gov.uk/pub/docs/doh/mhmain.pdf
Looking at this confirms what I suspected. Care homes are
unfashionable. In the whole long document they are hardly mentioned.
Public reaction to the "Care in the Community" policies means that
acute beds and secure beds get attention but other kinds of long- or
medium-term *staffed* care are just not trendy. (Whereas supported
accommodation, which is more in tune with the current emphasis on
independent living, gets more attention.)
At the end they do concede that certain "vital core services...must be
in place.....
- a range of services to respond effectively to a crisis, including
access to a place away from home if necessary
- adequate local treatment and care facilities, including local
inpatient beds, 24 hour staffed accommodation, day and residential
care." (p105)
In any case, this document is national policy, but not national
planning in detail. As they say, "Local health and social care
communities must translate the national standards and service models
into local delivery plans."
Planning is meant to be handled by Local Implementation Teams (LITs).
Searching with 'East Sussex' and 'Brighton' plus LIT or HIMP (Health
Improvement Plan) got me nowhere much. I hoped spending plans for
residential care would reveal more and found my way to the JIP (Joint
Investment Programme) for the "East Sussex, Brighton & Hove Health
Improvement Programme."
This isn't even up to date and it starts drearily:
"A senior level NSF Steering Group covering both East Sussex and
Brighton and Hove, consisting of directors or chief officers from
Social Services, Health Authority, Health Trusts and Primary Care
Groups, will lead on the county-wide implementation of the NSF. There
is a Local Implementation Group for Brighton and Hove, which reports
to the Steering Group. The local implementation group has a wider
membership to develop and deliver the local plans through 2000/2001.
The structure is shown in Appendix A. The task of developing the
Mental Health JIP has been delegated to this Implementation Group."
You'll find Health Authority and Social Services spending on mental
health for 1999-2000 in this document under section 9 "What do we
spend now?"
Section 4 reveals these figures:
1999-2000 2000-2001
Residential care £511,800 £535,100
short term/respite - £13,200
And apart from a few beds for the mentally ill homeless, the only
local authority homes seem to be:
24 HOUR NURSED CARE
Hanover Crescent, 10 beds
Rutland Gardens, 10 beds
://www.google.co.uk/search?q=cache:mACJPdsvoYcC:www.brighton-hove.gov.uk/downloads/jip/MHJIP.doc+%22Hanover+Crescent,+10+beds%22+mental+health+brighton&hl=en&ie=UTF-8
There is an update to the JIP that takes us into 2002. I think most of
the "residential" places mentioned in it are supported accommodation,
not staffed homes, but I'm afraid one would need local knowledge to
be sure.
East Sussex, Brighton & Hove Health Improvement Programme - JIP update
on funding to 2002
://www.google.co.uk/search?q=cache:m6-Vq9j7lRQC:www.brighton-hove.gov.uk/downloads/jip/MHJIPupdate.doc++site:www.brighton-hove.gov.uk+jip+%22mental+health%22+%22east+sussex%22+OR+brighton+2001+OR+2002+OR+2003&hl=en&ie=UTF-8
Sorry about the awful links to these documents. You can download them
as Word documents from here, if you prefer:
East Sussex, Brighton & Hove Health Improvement Programme - links to
JIP documents
http://www.brighton-hove.gov.uk/site01.cfm?request=c943
Frankly, it seems to me there is no planning for staffed residential
care. There *are* some mental health beds in staffed homes in East
Sussex and the costs are covered in the social services budget. But
no-one has any actual plans for keeping provision at that level - or
increasing it - or even reducing it.
If a home did close who's to say another one is needed? At present
mental health services are being reorganised so that eventually, in
2004-5, they will come under the new Care Trust. This replaces the
current set-up where things are split between the NHS and Social
Services.
In theory, individual clients' interests are protected by the CPA
policy. This means that each user of mental health services has a
personalised plan drawn up spelling out what provision s/he requires.
But none of the HIMPs, SaFFs, JIPs etc. show any sign of assessing how
many care home beds or staffed homes are needed.
But that's getting away from your question which was originally about
statistics past, present and future. I don't think there's much more
hard data to be found, certainly not online. Please remember that if
you want me to go into some particular aspect of all this that I
haven't focussed on enough, I would be very willing to answer
clarification requests. I found the whole thing surprisingly
interesting and enjoyed the challenge of fighting my way through the
acronyms.
Regards - Leli
P.S.
The National Statistics Office offers these categories:
"More detailed topics for Mental Health Services -
Admissions to psychiatric hospitals
Diagnosis of mentally ill patients
Discharges from psychiatric hospitals
Discharges of mentally ill patients
Duration of stay of mentally ill patients
Guardianship under the mental health act (1983)
Inpatient stays in psychiatric hospitals
Legal status of mentally ill patients
Mental category of mentally ill patients
Outpatient attendances at psychiatric hospitals"
http://www.statistics.gov.uk/CCI/Nscl.asp?ID=6437&Pos=1&ColRank=1&Rank=208
search terms:
"mental health" "residential care" "care homes" "staffed homes"
statistics data figures
"east sussex" brighton "social services"
HIMP SAFF JIP LIT
population estimate numbers "people in care" need needing requiring
"in need of" |
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