Mental Health Inpatient Census 2025 Part 3 - HBCCC and Long stay

Methodology & further information

The Inpatient Census was carried out on April 9 2025 by the Scottish Government and all NHS Boards. This was the ninth time the Census has been undertaken. The Census covered three parts:

• Part 1: Every patient occupying a psychiatric, addiction, or learning disability inpatient bed in an NHS Scotland facility on the census date.
• Part 2: Every mental health, addiction, or learning disability patient whose care is funded by NHS Scotland but is being treated in a facility outwith NHS Scotland.
• Part 3: Every patient who was in receipt of Hospital Based Complex Clinical Care (HBCCC) in general acute inpatient beds on the census date.This report covers all Hospital Based Complex Clinical Care and Long-Stay patients from Parts 1, 2, and 3. All 12 NHS Scotland territorial boards with psychiatric, addiction, or learning disability inpatient beds provided a return. The State Hospital (Special NHS Board) also provided a return.

The Scottish Government’s Digital Acquisition Services provide data collection and validation support for a number of statistical returns. Digital Acquisition Services provided secure data collection software (procxed.net) and first stage data validation checks. Further information about the data collection software can be found in the Data Privacy Impact Assessment which can be obtained on request from MHIC@gov.scot. Health & Social Care Analysis Division undertook second stage validation checks.

The data collection, analysis and reporting has been overseen and produced by Scottish Government statisticians. All statisticians in the Scottish Government are part of the Government Statistical Service (GSS) which comprises the statistics divisions of all major departments in the UK Government, and the devolved Governments of Scotland, Wales and Northern Ireland plus the Office for National Statistics, which has a coordinating role for the GSS.

Revisions to 2022 report and archiving of pre-2022 publications

As a result of a 2024 project to improve the internal coding used in the analysis of the census, some errors were discovered in the process used to collate the data needed to build the census datasets. These errors did not affect the data for the HBCCC and Long-Stay patient censuses. However, the pre-2022 HBCCC and Long-Stay censuses were archived alongside the pre-2022 Mental Health Bed censuses and Mental Health Inpatients Outwith NHS Scotland censuses.

Implementation of sex, transgender and equalities questions

Full details can be found in the 2025 Mental Health Inpatient Census Parts 1 and 2.

Religion or belief

A new question on religion or belief  was added to the Census in 2025. The question and response options were as follows:

Q - What religion, religious denomination or body does the patient belong to?

- 01 None
- 02 Church of Scotland
- 03 Roman Catholic
- 04 Other Christian, please write in
- 05 Muslim, write in denomination or school
- 06 Hindu
- 07 Buddhist
- 08 Sikh
- 09 Jewish
- 10 Pagan
- 11 Another religion or body, please write in
- 12 Refusal
- 13 Prefer not to say
- 14 Not known

And a follow-up question:

- If “04 Other Christian”, “05 Muslim, write in denomination or school”, or “11 Another religion or body, please write in” selected in P1:Q24. (freetext)

Sexual orientation

A new  question on sexual orientation was added to the Census in 2025. The question and response options were as follows:

Q -Which of the following best describes the patient’s sexual orientation?

- 01 Straight / heterosexual
- 02 Gay or Lesbian
- 03 Bisexual
- 04 Other sexual orientation, please write in
- 05 Refusal
- 06 Prefer not to say
- 07 Not known

And a follow-up question:

- Sexual orientation – Other: If answered 04 Other to Q26 (freetext)

Long-term illnesses

A new question on long term illnesses was added to the Census in 2025. The question and response options were as follows:

Q - Does the patient have any physical or mental health conditions or illnesses lasting or expected to last 12 months or more?

- 01 Yes
- 02 No
- 03 Not Known
- 04 Refusal
- 05 Prefer not to say

Follow-up questions:

Q - Do any of these conditions or illnesses lasting 12 months or more affect the patient in any of the following areas?

- 01 Vision (for example blindness or partial sight)
- 02 Hearing (for example deafness or partial hearing)
- 03 Mobility (for example walking short distances or climbing stairs)
- 04 Dexterity (for example lifting or carrying objects, using a keyboard)
- 05 Learning or understanding or concentrating
- 06 Memory
- 07 Mental health
- 08 Stamina or breathing or fatigue
- 09 Socially or behaviourally (for example associated with autism spectrum disorder (ASD) which includes Asperger's, or attention deficit hyperactivity disorder (ADHD))
- 10 Other (please specify)
- 11 None of the above
- 12 Refusal

Health conditions – Other:

- If the patient answered “Other” to P1:Q21, please specify. (FREE TEXT)

Q -Does the patient’s condition or illness/do any of the patient’s conditions or illnesses reduce their ability to carry-out day-to-day activities?

- 01 Yes, a lot
- 02 Yes, a little
- 03 Not at all
- 04 Refusal
- 05 Prefer not to say

The Census is one of the data collections that is part of the Equalities Data Improvement Programme (EDIP). The EDIP was a commitment to expand and make improvements to protected characteristics data. This was part of the wider Equality Evidence Strategy, published in March 2023. More details on this are provided in Scotland’s Equality Evidence Strategy 2023-2025.

Scottish Index of Multiple Deprivation (SIMD) and Urban/rural classifications

Patient data received by the Scottish Government includes a partial postcode (for example AB12 3). This protects the patient’s home address, but allows us to identify the datazone of the patient’s residence, and then to assign them to an SIMD quintile or decile. Similarly, the datazone allows us to identify the urban/rural classification of the patient’s residence.

For the 2025 census we have used this data to analyse the number and proportion of patients whose residences are in each SIMD quintile or urban/rural classification. We have excluded patients whose datazones were identical to a prison or a hospital, as this would not reflect the character of the area where their main residence was located.

Further information on SIMD and urban/rural classification is available here: Scottish Index of Multiple Deprivation 2020 [Scottish Government Urban Rural Classification 2022(https://www.gov.scot/publications/scottish-government-urban-rural-classification-2022/pages/introduction/)

Plans for future Censuses

It is our intention to run a consultation with the users of the Census to explore what content is most useful and to gather views on any changes users would like to see in the data collection and publication. We will post more information on our Census website as our planning for this develops.

Data confidentiality

A Data Protection Impact Assessment was undertaken prior to the Census which outlines how patient confidentiality is maintained. The Data Protection Impact Assessment can be obtained on request from MHIC@gov.scot.

In addition, statistical disclosure control has been applied to the analysis presnted. Statistical disclosure control  covers a range of ways of presenting data which are used to control the risk of an intruder finding out confidential information about a person or unit (such as a household or business). This publication has used the following methods where there are under five patients in a particular category:

• Suppression of possibly disclosive cells (e.g. where the value is small) which means that the value for that cell in the table is not given and secondary suppression of cells which means at least one other value in the row or column is also not given to ensure that disclosive cells cannot be deduced through subtraction.
• Table and chart redesign and recoding, where cells are grouped together to protect small value cells.

Further information about Statistical Disclosure Control is available here: Statistical disclosure control - Office for National Statistics (ons.gov.uk).

Health Conditions

The International Classification of Diseases (10th Revision) has been used in the analysis for specific health conditions. The health condition and relevant ICD-10 code can be found in the following table:

Access to the data for further research

To enable further research and statistical analysis, extracts of the Inpatient Census data may be made available for approved researchers. Academic researchers must initially apply to the ‘Statistics Public Benefit and Privacy Panel’ or the ‘Public Benefit and Privacy Panel for Health and Social Care’ to gain access to the Inpatient Census data.

If the ‘Statistics Public Benefit and Privacy Panel’ or the ‘Public Benefit and Privacy Panel for Health and Social Care’ approve an application then a copy of the original application form and a copy of the approval letter should be emailed to the following address MHIC@gov.scot for approval by the Scottish Government (Health & Social Care Analysis Division and the Principal Medical Officer for Mental Health).

NHS Boards will have a version of the Inpatient Census dataset which contains information about patients for whom they are responsible for providing treatment, or are responsible for funding. NHS boards will have their own arrangements in place for researchers to access health data.

All Boards have a Caldicott Guardian who is responsible for assuring confidentiality and enabling appropriate data sharing, and a director responsible for research and development.