(2) what mechanisms are in place (a) to record and (b) to publish the cause of death of inpatients who die in NHS mental health accommodation.
Information on the total number of in-patient deaths in national health service mental health accommodation in England from 2001-02 to 2005-06 is shown in the following table.
Number 2001-02 2,970 2002-03 2,920 2003-04 2,660 2004-05 2,490 2005-06 1,980 1 Totals include deaths from all causes Note: Ungrossed data: the figures have not been adjusted for shortfalls in data. Source: Hospital Episode Statistics, the Information Centre for Health and Social Care.
1 Totals include deaths from all causes
Ungrossed data: the figures have not been adjusted for shortfalls in data.
Hospital Episode Statistics, the Information Centre for Health and Social Care.
Data on in-patient deaths which are due to suicide, homicide and sudden, unexpected causes is published by the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness (NCISH) based at the University of Manchester. NCISH is funded by the National Patient Safety Agency and published its report, ‘Avoidable Deaths’, in December 2006. It covers data on homicides in England and Wales from April 1999 to December 2003 and on suicides from April 2000 to December 2004.
The data on homicides is collected from the Home Office Homicide Index (HI). Where available, psychiatric reports prepared for the trial are obtained. Information on previous offences is collected from the National Crime Operations Faculty. Case details are submitted to mental health services in each individual’s district of residence and adjacent districts to identify those with a history of using mental health services, including those with a lifetime contact. These individuals become inquiry cases and those cases with recent service contact (within 12 months of the offence) are analysed as the main sample.
Information on inquiry cases is obtained from a questionnaire sent to the consultant psychiatrist within the applicable clinical team. For all homicide convictions, data are collected on methods and victims from the HI, including data on diminished responsibility and hospital orders. Data on mental illness at the time of offence comes from psychiatric reports prepared for the Crown Prosecution Service, including details of mental health, drug and alcohol use at the time of the offence. The questionnaire also provides data covering demographic details, clinical history, details of the homicide, details of in-patient/community care received, details of final contact with services, events leading to the homicide and respondents’ views on prevention.
The Mental Health Act Commission (MHAC) collects data on all detained patient deaths and publishes data on those from non-natural causes in its biennial report. MHAC, under its general remit to keep under review the operation of the Mental Health Act 1983, asks providers to notify it of all deaths of detained patients within three working days.
MHAC reviews the deaths of patients who have died from non-natural causes to establish whether good practice, as defined in the ‘Mental Health Act 1983 Code of Practice’, has been followed and whether lessons for future practice and policy need to be learned. This review may include sending a Commissioner to the inquest, which considers the circumstances of the death or arranging a visit to the hospital to consider the issues arising.