Mental Health Inpatient Census 2025 - Parts 1 and 2

4. Adult patients treated in NHS Scotland facilities (additional detail)

Adult patients and demographics:

• There were 2889 adult patients aged 18 and over in the 2025 census.
• 70% of adult patients had one mental health condition, and 58% had a long-term physical health condition.
• 91% of adult patients received some form of physical health check.

Speciality of consultant and legislation

NHS Boards were asked to record the specialty of every consultant who was responsible for overseeing the treatment of a patient in the census. 1301 (45%) adult patients were seen by a consultant with a “General Psychiatry” specialty, while 867 (30%) were seen by a “Psychiatry of Old Age” specialist.

Table 15: Percentage of adult patients by consultant specialty.

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

Main Speciality	2016*	2017*	2018	2019*	2022	2023	2024	2025
Addictions	1%	1%	0%	1%	1%	0%	1%	2%
Forensic Psychiatry	12%	13%	14%	15%	13%	12%	14%	14%
General Psychiatry	43%	42%	42%	42%	39%	46%	42%	45%
Learning Disability (non forensic)	5%	5%	4%	4%	4%	4%	4%	4%
Psychiatry of Old Age	39%	38%	38%	36%	29%	31%	32%	30%

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

1 Does not include all consultant specialities due to small numbers

There are various legislations that patients can be subject to and it is possible for patients to be subject to more than one piece of legislation. Patients can be formally detained under the Mental Health (Care and Treatment) (Scotland) Act 2003.

• 1037 (36%) adult patients were subject to the Mental Health Act (Compulsory Treatment Order).
• 528 (18%) of adult patients were subject to the Adults with Incapacity (Scotland) Act 2000.

Figure 5: Type of formal detention.

Psychiatric, addiction or learning disability inpatients, NHS Scotland, 2025, census.

* the data for MHA – Nurse Holding Powers, CPA – Sections 59, 59A and Temporary Compulsion Order, and Regulation of Care (Scotland) Act 2001 have been included in Other Legislation due to small numbers.

** patients may be subject to more than one legislation.

Health and wellbeing

Mental health morbidities

70% of adult patients with known mental health conditions had one mental health condition. The most common mental health conditions were Schizophrenia (28%), Dementia (21%), and Schizotypal (13%).

Figure 6: Number of mental health conditions.

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

1 Figures prior to 2022 are missing some hospital wards and are approximate.

Diagnosis counts include both primary and secondary diagnoses. Additionally, separate questions on autistic spectrum disorder and personality disorder were included. This allows for the cross-comparison with diagnosis codes. This process ensures the identification of any patients missing relevant codes.

Learning disabilities and autism

Of the 2889 adult patients in the 2025 census, 309 (11%) had a diagnosis for either learning disability or autism. There were 167 (6%) adult patients with a diagnosis for learning disability and 223 (8%) with a diagnosis for autism (81 (3%) patients had a diagnosis for both).

Figure 7: Percentage of adult inpatients with selected mental health conditions.

Psychiatric, addiction or learning disability inpatients, NHS Scotland, 2025, census.

* Mental health diagnoses are based on ICD-10 codes. Primary and secondary diagnoses included

** Personality disorders and autistic spectrum disorder counts also rely on respective questions on these disorders

*** Patients may have more than one diagnosis

Physical health co-morbidities

The Mental Health Strategy 2017 – 2027 highlights the importance of addressing physical and mental health together as they are interconnected. Furthermore, the 2014 census identified the need to improve the recording of both mental and physical health conditions. To achieve this, mental health and learning disability services in NHS Boards are striving to routinely record physical health conditions using the International Classification of Diseases (ICD).

The 2025 census continued to include a set of Yes/No physical health questions, following the approach used in the 2016 census.

List of yes/no physical health morbidities questions in the census:

• Hypertension
• Diabetes
• Dyslipidaemia
• Chronic Obstructive Pulmonary Disease
• Coronary Heart Disease
• Chronic Pain
• Epilepsy
• Sensory Impairments
• Chronic Kidney Disease
• Liver Disease
• Thyroid Disease
• Acquired Brain Injury
• Cancer
• Stroke / Transient Ischaemic Attack
• Alcohol Acquired Brain Injury
• Parkinsons

In the 2025 census, there were 1663 (58%) adult patients with at least one physical health co-morbidity based on the physical health questions.

Among adult patients with a physical health co-morbidity, 40% had one long-term condition, while 15% had 4 or more physical health co-morbidities. The most common physical co-morbidities in the 2025 census were Hypertension (17%), Chronic Pain Condition (13%), and Diabetes (12%).

Figure 8: Inpatients Physical Health conditions.

Psychiatric, addiction or learning disability inpatients, NHS Scotland, 2025 census.

* Patients can have more than one physical health condition.

Physical health check

In the 2025 census, out of 1928 adult patients eligible, 1762 (91%) are known to have received a general physical examination within a day of admission. 27 patients (1%) were offered an examination but declined.

Regarding annual physical examinations, out of 823 adult patients eligible, 649 (79%) received a health check within the last year. Furthermore, 27 patients (3%) were offered an examination but declined.

Lifestyle factors

BMI (Body Mass Index)

BMI (Body Mass Index) was calculated for patients with available height and weight data. 86 patients who did not provide this information or had extreme values were excluded. Patients in eating disorder wards were also excluded.

Among the remaining adult patients, 922 (33%) had a healthy BMI, while 63% were classified as overweight or obese and 4% of patients were classified as underweight.

Table 16: Adult Patients BMI.

Psychiatric, addiction or learning disability inpatients, NHS Scotland, 2016 – 2025

BMI	2016*	2017*	2018	2019*	2022	2023	2024	2025
Healthy Weight	36%	37%	37%	36%	34%	34%	35%	33%
Obese	28%	28%	29%	30%	31%	32%	33%	34%
Overweight	31%	30%	30%	30%	30%	29%	28%	29%
Underweight	6%	6%	5%	5%	5%	5%	5%	4%

* These years figures are approximate due to some missing hospital ward data. ** Excludes patients in eating disorder wards *** 9 patients excluded due to missing data or extreme outliers

Smoking, alcohol and drug misuse

The census collects data on alcohol and substance misuse though it is important to note that not all patients with these issues will have a formal diagnosis so reported numbers may be underestimated.

This section presents analysis based on responses to specific questions. A minor methodological change was made in 2017 (see Section 7 for details).

In the 12 weeks prior to the 2025 census, 907 adult patients (32%) reported smoking tobacco.

Regarding alcohol dependence, 590 adult patients (21%) had a history of alcohol dependence in the four weeks before admission. Of these patients, 134 had an alcohol-related diagnosis, based on ICD-10 codes.

For substance abuse (excluding alcohol), 611 of adult patients (21%) reported using substances other than alcohol in the four weeks prior to admission. Of these, 115 (19%) had a diagnosis of substance misuse based on ICD-10 codes.

NHS Boards provided data on substances used by 414 adult patients with a history of substance misuse (excluding alcohol) in the four weeks before admission. The most common substance was Cannabis, used by 255 patients (62% of these patients).

Figure 9: History of Substance Use.

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

* Figures prior to 2022 are missing some hospital wards and are approximate.

Out of the 611 patients with a history of substance abuse, 361 (59%) used only one substance in the four weeks prior to admission. There were 78 (13%) using multiple substances in 2025.

Detailed substance information was not available for 334 patients.

Of those who had a history of substance abuse, 302 (49%) used smoke or nasal, 80 (13%) oral, and 19 (3%) by injection. Data was not known for 130 (21%). Patients may use multiple routes of substance abuse.

Self-harm

NHS Boards provided information on whether patients self-harmed in the week before admission. In the 2025 census, 253 adult patients (9%) had self-harmed in that week. The most common form of self-harm in the 2025 census was Non-accidental self-injury (63% of self harms). It is important to note that patients can self-harm in more than one way.

Of all adults self-harming in the week prior to admission, 40% were male, and 59% were female, 42% were aged 18-39, 40% were aged 40-64 and 18% 65 or over.

Suicidal ideation

NHS Boards provided information on whether patients expressed suicidal ideation on admission. In the 2025 census, there were 343 adult patients (12%) who expressed suicidal ideation on admission.

A roughly equal percentage of males and females expressed suicidal ideation. Individuals aged 40-64 (41%) were more likely to express suicidal ideation compared to other age groups  (18-39: 38%;  65+: 21%).