Mental Health Inpatient Census 2025 - 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 were the largest category of available beds in NHS Scotland (34%)
• Length of stay varied greatly among ward types, from an average of 6 days in Addiction Wards to 1359 days in Learning Disability unit (non Forensic) wards.
• Bed occupancy rates ranged from 76% in Forensic (LD) to 97% in Acute wards.

Table 8: Number of beds by ward type NHS Scotland.

Psychiatric, addiction or learning disability inpatients, NHS Scotland, March/April census, 2014 - 2025

Ward Type	2018	2019*	2022	2023	2024	2025
Acute	1141	1188	1037	1181	999	999
Addiction Wards	33	45	37	42	50	55
Admission & Assessment	154	147	170	137	225	235
Continuing care / long stay / recovery (non dementia)	275	206	230	209	138	102
Dementia Wards	706	645	485	517	571	544
Eating Disorder	12	18	7	7	13	9
Forensic (LD)	67	60	64	49	60	51
Forensic (non-LD)	367	358	322	325	319	319
IPCU	125	104	110	109	119	102
Learning Disability unit (non Forensic)	148	147	132	125	124	109
Other	86	11	0	0	53	39
Perinatal	12	11	5	5	5	-
Rehabilitation (non addiction)	264	323	313	308	324	332
Young People/Children	53	47	47	44	41	45
All Wards	3443	3310	2959	3058	3041	2941

* 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: Occupancy rate by ward type, NHS Scotland.

Psychiatric, addiction or learning disability inpatients, NHS Scotland, March/April census, 2014 - 2025

Ward Type	2018	2019	2022	2023	2024	2025
Acute	86%	88%	86%	93%	98%	97%
Addiction Wards	82%	102%	70%	70%	75%	92%
Admission & Assessment	89%	91%	93%	86%	90%	81%
Continuing care / long stay / recovery (non dementia)	68%	86%	84%	85%	88%	83%
Dementia Wards	87%	75%	81%	87%	85%	91%
Eating Disorder	55%	82%	70%	70%	93%	90%
Forensic (LD)	85%	88%	81%	83%	86%	76%
Forensic (non-LD)	90%	90%	90%	92%	88%	88%
IPCU	87%	78%	87%	97%	93%	80%
Learning Disability unit (non Forensic)	87%	77%	88%	81%	87%	89%
Other	76%	92%	-	-	98%	83%
Perinatal	100%	92%	83%	100%	83%	-
Rehabilitation (non addiction)	85%	85%	88%	87%	88%	87%
Young People/Children	98%	87%	87%	81%	79%	87%
All Wards	84%	84%	85%	89%	90%	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 (69%) were in General Psychiatric Ward, and 15% 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 69% 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, 2025, census.

* Other security includes: Open Forensic Ward, Community Facility, Intensive Care Psychiatric Unit. ** Excludes a number of cases where ward security returned “Not applicable” (237 inpatients).

Observation level

Wards vary in observation 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 2025 census, the majority of patients (2641 or 90%) were under General Observation. However, some wards, such as Learning Disability 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, 2025, census.

Patients under Constant, Special, or Enhanced Observation, need a high level of staff resources. Out of the 274 patients under these levels, 69 (25%) required 2 or more staff members for supervision. This varied across ward types.

For example, in Children’s Unit wards, all patients needed one staff member for supervision. In IPCU wards, 50% of patients required 2 staff members, in Forensic (LD) wards 40% required 3 staff members, and in Learning Disability unit (non Forensic) wards 4% required 4 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” (38%) and “Risk of self harm” (26%).

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 2025 census, around 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 6 months (193 days). Patients with current Informal status had an average stay of about 2 months (56 days).

Table 10: Percentage of inpatients with a “Formal” status at time of census.

Psychiatric, addiction or learning disability inpatients, NHS Scotland, March/April census, 2025

Ward Type	frequency
Acute	60%
Addiction Wards	0%
Admission & Assessment	49%
Continuing care / long stay / recovery (non dementia)	64%
Dementia Wards	43%
Eating Disorder	44%
Forensic (LD)	100%
Forensic (non-LD)	98%
IPCU	100%
Learning Disability unit (non Forensic)	95%
Other	77%
Rehabilitation (non addiction)	83%
Young People/Children	71%

Hospital Based Complex Clinical Care (HBCCC)

At the 2025 census, patients receiving HBCCC had longer stays compared to those without HBCCC. HBCCC patients had an average (median) length of stay of about 93 days. Patients without HBCCC had an average stay of about 446 days.

There were 356 (12%) patients receiving HBCCC in mental health or learning disability inpatient beds at the 2025 census. These patients were most likely to be treated in Dementia Wards (44% of HBCCC patients). Although most HBCCC patients are in wards with longer lengths of stay, 4% are in Acute wards.

Table 11: Number of HBCCC patients by selected ward type, NHS Scotland

Psychiatric, addiction or learning disability inpatients, NHS Scotland, March/April census 2017 – 2025

Ward Type	2017	2018	2019	2022	2023	2024	2025
Acute	86	37	65	c	57	64	41
Continuing care / long stay / recovery (non dementia)	286	171	140	119	103	57	50
Dementia Wards	218	321	328	166	180	192	157
Forensic (LD)	-	-	-	c	-	c	c
Rehabilitation (non addiction)	98	65	57	64	83	52	53

1 Dementia wards are the combination of dementia assessment and dementia care & treatment wards. c – data suppressed due to small numbers.

 

Table 12: the percentage of inpatients in that ward type who are receiving HBCCC, by selected ward type, NHS Scotland.

Psychiatric, addiction or learning disability inpatients, NHS Scotland, March/April census 2017 – 2025

Ward Type	2017	2018	2019	2022	2023	2024	2025
Acute	6%	3%	5%	1%	5	6%	4%
Continuing care / long stay / recovery (non dementia)	77%	62%	68%	29%	49	41%	49%
Dementia Wards	32%	45%	51%	40%	35	34%	29%
Forensic (LD)	0%	0%	0%	0%	-	c	c
Rehabilitation (non addiction)	38%	25%	18%	16%	27	16%	16%

1 Dementia wards are the combination of dementia assessment and dementia care & treatment wards. c – data suppressed due to small numbers.

Delayed Discharge

Timely discharge from the hospital is an indicator of quality care. It reflects person-centred, effective, integrated, and harm-free treatment. Delayed discharge happens when a hospital patient who is ready for discharge continues to occupy a bed.

In the 2025 census, there were 311 patients (11%) experiencing delayed discharge (DD). Most of them were in Dementia Wards (24% of DD’s or 76 inpatients), Learning Disability unit (non Forensic) (21% or 65 inpatients) and Acute (17% of DD’s or 53 inpatients).

The longest delays were observed in patients in Learning Disability unit (non Forensic) (643 days delayed), followed by Continuing care / long stay / recovery (non dementia) (336 days delayed), and IPCU (264 days delayed).

Patients in Addiction Wards (6 days), Admission & Assessment (41 days), and Acute wards (42 days) had short delays.

The proportion of patients experiencing delayed discharge ranged from 2% in Addiction Wards, to 60% in Learning Disability unit (non Forensic). 

11% of Female inpatients experienced delayed discharge.12% of those aged 0-39 experience delayed discharge. Those aged under 40 years old had the longest length of delay (254 days).

Of all patients with Dementia, 14% experienced delayed discharge, while 12% of Personality Disorder patients and 11% of Neurotic Stress patients experienced delayed discharge.

Table 13: Delayed Discharges by Health board - Percentage of patients treated by that health board who experienced delayed discharge

Psychiatric, addiction or learning disability inpatients, NHS Scotland 2025

NHS Board	2025
NHS Ayrshire & Arran	16%
NHS Borders	22%
NHS Dumfries & Galloway	32%
NHS Fife	14%
NHS Forth Valley	10%
NHS Grampian	12%
NHS Greater Glasgow & Clyde	6%
NHS Highland	19%
NHS Lanarkshire	11%
NHS Lothian	10%
NHS Tayside	11%
NHS Western Isles	33%
State Hospital	0%
Scotland	11%

The most common reason for delayed discharge was “Awaiting place availability in LA residential home” (35, 11% of delayed discharges with a median delay of 41 days), followed by “Awaiting place availability in specialist facility for high level younger age groups (<65) not currently available” (33, 11%, median delay of 554 days) and “Awaiting place availability in specialist residential facility for younger age groups (<65)” (23, 7%, median delay of 252 days.

Length of stay in different wards

The national average (median) length of stay for patients is 119 days though this duration varies across different ward types. For instance, patients in Learning Disability units (non Forensic) have the longest average stay, at 1359 days. This is followed by patients in Forensic (LD) (1120 days) and Forensic (non-LD) wards at 946 days.

Table 14: Average (median) length of stay (days) by ward type.

Psychiatric, addiction or learning disability inpatients and beds, NHS Scotland, March/April census, 2016 – 2025

Ward Type	2016*	2017*	2018	2019*	2022	2023	2024	2025
Acute	41	41	36	40	47	49	49	42
Addiction Wards	13	7	7	7	7	7	6	6
Admission & Assessment	NA	NA	40	50	46	52	49	41
Childrens Unit	58	104	78	59	48	79	29	55
Continuing care / long stay / recovery (non dementia)	1462	1255	1170	1318	694	735	867	726
Dementia Wards	205	206	204	269	160	169	147	163
Eating Disorder	90	85	88	100	68	78	49	56
Forensic (LD)	1708	1371	1398	1450	1395	1434	1230	1120
Forensic (non-LD)	861	832	779	922	1046	890	855	946
IPCU	64	57	54	56	66	56	57	74
Learning Disability unit (non Forensic)	840	1401	447	799	1564	1217	1096	1359
Other	64	170	137	239	-	-	70	328
Perinatal	46	8	6	20	8	29	8	-
Rehabilitation (non addiction)	770	840	537	582	677	722	697	531
Young peoples unit	36	42	69	42	31	72	64	56
All Wards	147	156	136	142	133	140	132	119

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