Mental Health Inpatient Census 2024 - Parts 1 and 2

2. Ward Type Breakdowns

Bed Categories and Occupancy

This section presents statistics broken down at ward level. Pressures and demands vary across different ward types. Some wards, like continuing care/long stay, had more stable populations compared to acute wards.

• Acute wards were the largest category of available beds in NHS Scotland (30%)
• Length of stay varied greatly among ward types, from a median of 6 days in Addiction wards to 1,230 days in Forensic (LD) wards.
• Bed occupancy rates ranged from 75% in Addiction wards to 98% in Acute wards.

Occupancy rates for psychiatric, addiction or learning disability beds in NHS Scotland have risen since the previous census.
Table: 8: Number of  inpatients by ward type NHS Scotland, March/April Census 2018 – 2024

Psychiatric, addiction or learning disability inpatients, NHS Scotland, March/April Census 2018 – 2024.

Ward Type	2018	2019*	2022	2023	2024
Acute	1,141	1,188	1,037	1,181	999
Addiction Wards	33	45	37	42	50
Admission & Assessment	154	147	170	137	225
Continuing care / long stay / recovery (non dementia)	275	206	230	209	138
Dementia Wards	706	645	485	517	571
Eating Disorder	12	18	7	7	13
Forensic (LD)	67	60	64	49	60
Forensic (non-LD)	367	358	322	325	319
ICPU*	125	104	110	109	119
Learning Disability unit (non Forensic)	148	147	132	125	124
Other (please specify)	86	11	0	0	53
Perinatal	12	11	5	5	5
Rehabilitation (non addiction)	264	323	313	308	324
Young People/Children	53	47	47	44	41
All Wards	3,443	3,310	2,959	3,058	3,041

* 2019 is missing some hospital wards and figures are approximate.

¹ Addiction wards are the combination of addiction rehabilitation and addiction detox wards.

² Dementia wards are the combination of dementia assessment and dementia care & treatment wards.

³ Young People/Children wards are the combination of Young people’s units and children’s units.

Table 9: Number of  beds by ward type NHS Scotland, March/April Census 2018 – 2024

Psychiatric, addiction or learning disability beds, NHS Scotland, March/April Census 2018 – 2024.

Ward Type	2018	2019*	2022	2023	2024
Acute	1,331	1,352	1,204	1,272	1,019
Addiction Wards	455	511	53	60	67
Admission & Assessment	173	161	183	160	249
Continuing care / long stay / recovery (non dementia)	402	239	274	246	157
Dementia Wards	814	858	602	596	674
Eating Disorder	22	22	10	10	14
Forensic (LD)	79	68	79	59	70
Forensic (non-LD)	410	399	356	355	364
ICPU*	144	133	126	112	128
Learning Disability unit (non Forensic)	170	190	150	154	142
Other (please specify)	113	12	0	0	54
Perinatal	12	12	6	5	6
Rehabilitation (non addiction)	311	378	354	353	370
Young People/Children	54	54	54	54	52
All Wards	4,490	4,389	3,451	3,436	3,366

* 2019 is missing some hospital wards and figures are approximate.

¹ Addiction wards are the combination of addiction rehabilitation and addiction detox wards.

² Dementia wards are the combination of dementia assessment and dementia care & treatment wards.

³ Young People/Children wards are the combination of young people’s units and children’s units.

Table 10: Occupancy rate by ward type NHS Scotland, March/April Census 2018 – 2024

Psychiatric, addiction or learning disability inpatients and beds, NHS Scotland, March/April Census 2018 – 2024.

Ward Type		2018		2019*	2022	2023	2024
Acute		86		88	86	93	98
Addiction Wards		87		78	70	70	75
Admission & Assessment		85		85	93	86	90
Continuing care / long stay / recovery (non dementia)		83		102	84	85	88
Dementia Wards		68		86	81	87	85
Eating Disorder		100		92	70	70	93
Forensic (LD)		90		90	81	83	86
Forensic (non-LD)		85		88	90	92	88
ICPU*		87		75	87	87	93
Learning Disability unit (non Forensic)		98		87	88	81	87
Other (please specify)		87		77	-	-	98
Perinatal		55		82	83	100	83
Rehabilitation (non addiction)		89		91	88	87	88
Young People/Children		76		92	87	81	79
All Wards	84		84		85	89	90

* 2019 is missing some hospital wards and figures are approximate.

¹ Addiction wards are the combination of addiction rehabilitation and addiction detox wards.

² Dementia wards are the combination of dementia assessment and dementia care & treatment wards.

³ Young People/Children wards are the combination of Young people’s units and children’s units.

Ward Security Levels

Wards have varying levels of security. This can affect unrestricted communication, visitor access, and patient movements. Most patients (70%) were in General Psychiatric ward, and 16% were in wards with low, medium, or high security levels.

Patients in these wards usually require more attention and higher staff resources. Since 2016, there has been a decrease from 74% to 70% in the proportion of patients treated in General Psychiatric wards. 

In most ward types, “General Psychiatric” is the most common security level and is the only security level for Acute, Addiction, Continuing/Long Stay, Young People/Children, Perinatal, and Eating Disorder wards. However, some ward types have more varied security levels, likely reflecting the complex nature of the cases they deal with. Only Forensic wards included a “High Security” level.

Figure 2: Ward security levels

Psychiatric, addiction or learning disability beds, NHS Scotland, 2024 census

*Other security includes: Open Forensic Ward, Community Facility, Intensive Care Psychiatric Unit.

**Excludes a number of cases where ward security returned “Not applicable” (243 inpatients).

Observation level

Wards vary in security levels. These levels are based on patients’ individual needs but can impact staff resources. The observation levels recorded at the time of the Census are:

• “General Observation” – Staff should know the patients’ general whereabouts.
• “Constant Observation” – Staff should constantly know the precise whereabouts of the patient.
• “Special Observation” – Patients should be in sight and within arm’s reach of a staff member.
• “Enhanced Care Plan For Therapeutic Engagement” – Aims to improve observation through therapeutic engagement with suicidal, violent, or vulnerable patients to prevent harm during their recovery at times of high risk.

During the 2024 Census, the majority of patients (2700 patients or 89%) were under General Observation. However, some wards, such as Rehabilitation wards and Acute wards, had more patients requiring higher levels of observation.

Figure 3: Patients under Constant, Special, or Enhanced Observation

Psychiatric, addiction or learning disability inpatients, NHS Scotland, 2024 census

Patients under Constant, Special, or Enhanced Observation, need a high level of staff resources. Out of the 297 patients under these levels, 61 (25%) required 2 or more staff members for supervision. This varied across ward types.

In Forensic (non-LD) wards, 55% of patients required 2 or more staff members and in Learning Disability unit (non Forensic) wards 5% required 4 or more staff members for higher levels of observation.

The most common reasons for patients being on Constant, Special, or Enhanced Observation, were “Risk of harm to others” (34%), “Risk of self harm” (19%), and “Falls” (15%).

Note that patients may be under observation for multiple reasons, such as being a risk to themselves or to others.

Formal Status and Length of Stay

Patients can have two types of status under the provisions of the Mental Health (Care and Treatment) (Scotland) Act of 2003:

• Formal status: This refers to patients who have been detained under the Act.
• Informal status: This refers to patients who have been admitted to mental health facilities voluntarily.

In the 2024 Census, 64% of patients had a Formal status. This status can change during their stay.

There are large differences in the lengths of stay between patients with Formal and Informal status. Current patients with Formal status had an average (median) stay of about 7 months (225 days). Patients with current Informal status had an average stay of about 2 months (63 days).

Table: 11: Percentage of inpatients with a “Formal” status at time of Census by ward type

Psychiatric, addiction or learning disability inpatients, NHS Scotland, 2024 Census.

Ward Type	Percentage
Acute	56%
Addiction Wards	0%
Admission & Assessment	52%
Continuing care / long stay / recovery (non dementia)	71%
Dementia Wards	40%
Eating Disorder	38%
Forensic (LD)	98%
Forensic (non-LD)	99%
ICPU*	98%
Learning Disability unit (non Forensic)	94%
Other (please specify)	49%
Perinatal	20%
Rehabilitation (non addiction)	81%
Young People/Children	71%
All Wards	64%

* Formal status data was missing for 2 patients in acute wards.

Hospital Based Complex Clinical Care (HBCCC)

At the 2024 Census, patients receiving HBCCC had longer stays compared to those without HBCCC. HBCCC patients had an average (median) length of stay of 444 days. Patients without HBCCC had an average stay of 111 days.

There were 447 (15%) patients receiving HBCCC in mental health or learning disability inpatient beds at the 2024 Census. Most of these patients (43%) were being treated in Dementia wards. Although most HBCCC patients are in wards with longer lengths of stay, 6% are in Acute wards.

Table: 12: Number of HBCCC patients by selected ward type, with count and percentage combined in a single column.

Psychiatric, addiction or learning disability inpatients, NHS Scotland, March/April Census 2017 – 2024.

Ward Type	2017*	2018	2019*	2022	2023	2024
Acute	86 (6.4%)	37 (3.2%)	65 (5.5%)	c (<1%)	57 (4.8%)	64 (6.4%)
Continuing care / long stay / recovery (non dementia)	286 (77%)	171 (62%)	140 (68%)	119 (29%)	103 (49%)	57 (41%)
Dementia Wards**	218 (32%)	321 (45%)	328 (51%)	166 (40%)	180 (35%)	192 (34%)
Forensic (non-LD)	131 (38%)	64 (17%)	101 (28%)	12 (3%)	48 (15%)	39 (12%)
Rehabilitation (non addiction)	98 (38%)	65 (25%)	57 (18%)	64 (16%)	83 (27%)	52 (16%)
All wards	924 (26%)	731 (21%)	742 (22%)	409 (14%)	509 (17%)	447 (15%)

* These years are missing some hospital wards and figures are approximate.

¹ Dementia wards are the combination of dementia assessment and dementia care & treatment wards.

c – data suppressed due to small numbers. Secondary suppression also applied.

Delayed Discharge

Release of the delayed discharge data for the Scottish Government’s 2024 Mental Health Inpatient Census has been delayed because we are engaged in an ongoing data quality assurance and validation process with health boards to ensure the data provided on this topic is robust.

Previous years’ delayed discharge data can be found in the 2023 census:

Mental Health Inpatient Census 2023 - Parts 1 and 2 - gov.scot

Length of Stay in Different Wards

The national average (median) length of stay for patients is 132 days, though the duration varies across different ward types. For instance, patients in Forensic (LD) have the longest average stay, at 1,230 days. This is followed by patients in Learning Disability unit (non Forensic) (1,096 days) and continuing care / long stay / recovery (non dementia) wards at 868 days.

Table 13: Average (median) length of stay (days) by ward type.

Psychiatric, addiction or learning disability inpatients and beds, NHS Scotland, March/April Census 2016 – 2024.

Ward Type	2016*	2017*	2018	2019*	2022	2023	2024
Acute	41	41	36	40	47	49	49
Addiction Wards	13	7	7	7	7	7	6
Admission & Assessment	-	-	40.5	50	46	52	49
Childrens Unit	58	104	77.5	59	48	79	29
Continuing care / long stay / recovery (non dementia)	1,462.5	1,255	1,170	1,318	694	735	867
Dementia Wards	205	206	204	269	160	169	147
Eating Disorder	90	85	87.5	99.5	68	78	49
Forensic (LD)	1,708.5	1,371	1,398	1,450.5	1,395	1,434	1,230
Forensic (non-LD)	861	832	779	921.5	1046	890	855
ICPU*	64.5	57	54	56.5	66	56	57
Learning Disability unit (non Forensic)	840	1401	447	799	1.564	1,217	1,096
Other (please specify)	64.5	170	137	239	-	-	70
Perinatal	45.5	8	6.5	20	8	29	8
Rehabilitation (non addiction)	770	840	537	582	677	721.5	697
Young peoples unit	35.5	42	69	42	31	71.5	64

*These years’ figures are approximate due to some missing hospital ward data.

Admission and Assessment was first included as a ward type in 2018. There were no "Other" wards in 2022 and 2023.