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WRITTEN QUESTION TO THE MINISTER FOR HEALTH AND SOCIAL SERVICES BY DEPUTY M.R. HIGGINS OF ST. HELIER
ANSWER TO BE TABLED ON TUESDAY 15th JANUARY 2013
Question
Over the last five years how many patients have been confined in Orchard House, the medical classifications used for their confinement and what medication was usually prescribed for each particular classification?
How many patients were re-admitted over that five year term? How many patients, if any, committed suicide after their treatment?
Answer
Over the last 5 years 1172 patients have been admitted to Orchard House, as shown in Table 1. 362 were admitted under Orders under Mental Health (jersey) Law 1969, and 810 were admitted voluntarily.
Medications and reasons for admission vary on a case-by-case basis so it is not possible to provide an accurate breakdown without interrogating every individual patient's health record.
With regard to reasons for admission however, the most common presentations to Orchard House include people who are in crisis or at risk due to depression, psychoses (such as schizophrenia), bi-polar disorder and to a lesser extent severe anxiety disorders. The unit also has a dedicated detoxification facility which enables two persons per week to address their alcohol or drug dependency whilst experiencing poor mental health.
For those admitted under Order, Table 2 shows a breakdown of the different orders used over the 5 year period.
Medications vary on a case by case basis. All medication regimes in Orchard House are informed by the National Institute for Clinical Excellence (NICE) and prescribed in accordance with the British National Formulary (BNF). This will include mood stabilisers, antipsychotic medications, antidepressants, and medications for insomnia, and to a lesser extent anxiolytic.
Most mental health problems have a high risk of recurrence within a one year period, for example 40-50% in psychosis, therefore in mental health the readmission rates are defined as the person returning to hospital within one year of being discharged. A review of 2012 readmission rates for Orchard House indicates that we have a 10% readmission rate. This is in keeping within the national averages.
With regard to suicide rates, Table Three shows total number of adult suicides in Jersey and, of those, numbers of patients who had been at Orchard House in previous five years.
TABLE 1 – INPATIENT SUMMARY INFORMATION
| 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | TOTAL |
Inpatient admissions to Orchard House | 223 | 202 | 163 | 181 | 228 | 175 | 1172 |
No of admissions under Orders | 81 | 93 | 52 | 39 | 54 | 43 | 362 |
No of voluntary admission | 142 | 109 | 111 | 142 | 174 | 132 | 810 |
Percentage of admissions under Order to voluntary admissions | 36% | 46% | 32% | 22% | 24% | 25% | 31% |
TABLE 2 – USE OF ORDERS UNDER MENTAL HEALTH (JERSEY) LAW, 1969 FOR CLIENTS ADMITTED TO ORCHARD HOUSE
TYPE OF ORDER | 2007 | 2008 | 2009 | 2010 | 2011 | 2012 | TOTAL |
Nurses Holding Power | 2 | 1 | 3 | 1 | 0 | 0 | 7 |
Emergency Orders Article 10 | 13 | 13 | 5 | 3 | 1 | 2 | 37 |
Observation Orders Article 6 | 33 | 33 | 14 | 6 | 22 | 21 | 129 |
Treatment Orders Article 7 | 30 | 46 | 30 | 29 | 31 | 20 | 186 |
Guardianship Orders Article 14 | 3 | 0 | 0 | 0 | 0 | 0 | 3 |
Total | 81 | 93 | 52 | 39 | 54 | 43 | 362 |
TABLE 3 – SUICIDE POPULATIONS
| 2007 | 2008 | 2009 | 2010 | 2011 | 2012 |
Total number of suicides in the adult population in Jersey. | 11 | 15 | 20 | 9 | 10 | 8* |
Number who were inpatients in the previous 5 years | 0 | 3 | 2 | 1 | 3 | 0 |
*The data for 2012 is incomplete due to cases being processed by the Viscounts Office.