Patients in mental health hospitals and units: as at 31 March 2024
Data on residents in NHS hospitals and units for people with a mental illness or a learning disability as at 31 March 2024.
This file may not be fully accessible.
In this page
Introduction
This release presents summary results from the 2021, 2022, 2023 and 2024 Psychiatric Census. Each year, at 31 March, a snapshot census is taken of the number of residents in NHS hospitals and units for people with a mental illness or a learning disability.
The Mental Health Act 1983 (UK legislation), amended in 2007, allows people with a mental disorder to be admitted to hospital, detained and treated without their consent; whether for their own health, safety, or for the protection of other people.
People can be admitted, detained and treated under different sections of the Mental Health Act. People who are compulsorily admitted to hospital are referred to as ‘formal’ patients and people who are admitted to hospital when they are unwell without the use of compulsory powers are referred to as ‘informal’ patients.
No data was collected in 2020 due to the COVID-19 pandemic response, and 2021 and 2022 data was strongly affected by it. As a result, detailed data comparisons for these years with the wider timeline should be avoided. As some hospitals reported a change in practice to reduce numbers of resident patients in mental health facilities at this time, with greater provision of services within the community.
This release focusses on the most recent year and provides a ten-year time series for certain analyses. Summary data included in this release broken down by local health board is available on StatsWales.
Main points
Resident patients with a mental illness, at 31 March 2024
- There were 1,192 resident patients, 14 (1%) more than 2023 but 249 (17%) less than 2015.
- The majority (58%) were formally detained under the Mental Health Act 1983 and other legislation; this was only the third time over the last decade (including 3 out of the last 4 years) that over half of patients were formally detained under the Act, rather than being informally admitted.
- The majority (58%) were being treated under the adult mental illness specialty, which has been the case in each year over the last decade.
- Around half (50.3%) of patients duration of stay was less than 3 months, which has mostly been the most common over the last decade, though the proportion of these has been falling. Whilst 8% of patients stay was 2 years or over.
- Most (59%) were male, and this proportion increased for formally detained patients where 63% were male. These proportions have remained relatively stable over the last decade.
- The most common age group were 65 years or older (35%), though the proportion in this age group has fallen substantially over the last decade.
- Most (93.5%) were from a White ethnic group but at similar proportions to those in the general population; a higher proportion of patients (2%) were from a Black/Black British/Caribbean or African ethnic group compared to the general population (0.9%).
Resident patients with a Learning disability, at 31 March 2024
- Learning disability data is based on small numbers of patients; therefore, can be volatile from year to year, more emphasis should be placed on longer term trends.
- There were 69 resident patients, an increase of 3 (5%) from 2023 but 56 (45%) less than 2015.
- 48% were formally detained under the Mental Health Act 1983 and other legislation, the highest proportion recorded.
- The majority (62%) were male, with 45 to 64 the most common age group (46%), and over 3 months but less than 2 years the most common duration of stay (42%); these have remained the most common characteristics over the decade except of length of stay, where 2 years or over was most common until the last 3 years.
Patients in mental health hospitals and units for people with a mental illness
Method of admission
Figure 1: Number of resident patients in mental health hospitals and units with a mental illness by method of admission at 31 March, 2015 to 2024
Description of Figure 1: Line chart showing that the number of informal mental illness resident patients has decreased over the last 10 years whilst the formal has steadily risen and has now overtaken informal patients.
Source: Psychiatric Census collection, Welsh Government
Patients in mental health hospitals and units in Wales with a mental illness on Statswales
[Note 1] Due to the COVID-19 pandemic the psychiatric census was suspended for 2020, therefore no data is available.
At 31 March 2024 there were 1,192 resident patients with a mental illness in mental health hospitals and units, 14 (1%) more than 2023 but 249 (17%) less than 2015. 58% (687) of these were formal patients whilst 42% (505) were informal patients.
Over the last decade there has been a downward trend in the overall number of resident patients, which has been driven by a fall in the number of informal patients.
Overall, the percentage of informal patients has decreased from 61% in 2015 to 42% in 2024 with the number falling by 370 from 875 in 2015 to 505 in 2024, a decrease of 42%.
In contrast, the percentage of formally detained patients has increased over the last decade from 39% in 2015 to 58% in 2024, with the number rising from 566 in 2015 to 687 in 2024, an increase of 21%.
This was only the third time over the last decade, including 3 out of the last 4 years, that over half of patients were formally detained under the Act, rather than being informally admitted.
37% of all resident patients with a mental illness were accommodated at the four largest hospitals or units (Hafan y coed, Cefn Coed, Llandough and Wrexham Maelor) and 62% of all resident patients with a mental illness were accommodated in the 10 largest hospitals or units in Wales.
Treatment specialty
Figure 2: Number of resident patients in mental health hospitals and units with a mental illness by specialty at 31 March, 2015 to 2024
Description of Figure 2: Line chart showing most resident patients are being treated for adult mental illness over the last decade. With a decline in the number of patients treated under the old age psychiatry specialty.
Source: Psychiatric Census collection, Welsh Government
[Note 1] Due to the COVID-19 pandemic the psychiatric census was suspended for 2020, therefore no data is available.
In the last 10 years the number of resident patients in the adult mental illness, forensic psychiatry and child and adolescent psychiatry specialties have stayed broadly similar. However the number of patients treated under the old age psychiatry specialty fell by 42% from 650 in 2015 to 378 in 2024.
At 31 March 2024, 58% of patients were being treated under the adult mental illness specialty compared to 1.3% child and adolescent psychiatry, 9% forensic psychiatry and 32% old age psychiatry.
Male patients accounted for 91% (100 out of 110) of the total forensic psychiatry residents, while female patients accounted for 81% (13 of 16) of the total child and adolescent psychiatry residents.
Length of stay
Figure 3: Number of resident patients in mental health hospitals and units with a mental illness by length of stay at 31 March, 2015 to 2024
Description of Figure 3: Line chart showing that most patients duration of stay is less than 3 months and has broadly been the case over the last decade, though the number of these are falling. There has also been a decline in the number of patients staying 2 years and over.
Source: Psychiatric Census collection, Welsh Government
[Note 1] Due to the COVID-19 pandemic the psychiatric census was suspended for 2020, therefore no data is available.
In the last 10 years the number of resident patients with a duration of stay of less than 3 months fell from 780 in 2015 to 599 in 2024, a decrease of 23%.
The number of patients with a duration of stay of 2 years or over has almost halved (48%) from 174 in 2015 to 90 in 2024.
At 31 March 2024, 50% of patients duration of stay was less than 3 months compared to 42% 3 months to less than 2 years and 8% 2 years or over.
Male patients accounted for 92% (83 out of 90) of the total residents with a duration of stay 2 years and over. This is a large increase from 2015 when they accounted for 60% (104 out of 174) of total residents. In this time the female patient total with a duration of stay 2 years or over has fallen from 70 in 2015 to 7 in 2024, a decrease of 90%.
Characteristics of patients
Figure 4: Number of resident patients in mental health hospitals and units with a mental illness by sex at 31 March, 2015 to 2024
Description of Figure 4: A line chart showing that the number of male and female resident patients has decreased over the last 10 years, but there has been consistently more male than female residents each year.
Source: Psychiatric Census collection, Welsh Government
[Note 1] Due to the COVID-19 pandemic the psychiatric census was suspended for 2020, therefore no data is available.
At 31 March 2024 when there were 1,192 resident patients with a mental illness, there were 703 males, down 11% from 791 in 2015 and 489 females, down 25% from 650 in 2015.
In 2024 the female patients continued to increase having done so each year from 2021, rising from 474 in 2023 to 489 in 2024.
59% of patients were male compared with 41% being female, continuing the trend of more males being patients than females in each of the last 10 years. Though this gap appears to be narrowing over the last 3 years after previously widening.
Figure 5: Number of resident patients in mental health hospitals and units with a mental illness by age group at 31 March, 2015 to 2024
Description of Figure 5: Line chart showing the most common resident patients by age group was 65 and over but that the number in this age group has fallen considerably over the last decade.
Source: Psychiatric Census collection, Welsh Government
[Note 1] Due to the COVID-19 pandemic the psychiatric census was suspended for 2020, therefore no data is available.
In the last 10 years the number of young resident patients (under 25) has increased whilst the number of older patients (65 and older) has significantly decreased.
At 31 March the number of patients aged under 25 rose from 93 in 2015 to 115 in 2024, an increase of 24%. Whilst the number of patients aged 65 and over fell from 679 in 2015 to 412 in 2024, a decrease of 39%.
In 2024 10% of patients were under 25 years old; 30% were 25 to 44 years old; 26% were 45 to 64 years old and 35% were 65 years or older. This compares to 6% in under 25 and 47% in patients 65 or older in 2015.
When looking by age group and sex, the number of resident patients are similar in the under 25 and 65 and over age groups. But there is roughly double the number of males than female in the 25 to 44 and 45 to 64 age groups.
Figure 6: Percentage of resident patients in mental health hospitals and units with a mental illness by ethnicity compared to the wider population at 31 March 2024
Description for Figure 6: Bar chart showing the large majority of mental illness resident patients were recorded in the White ethnic group (93.5%). The next highest ethnic group was Black/Black British/Caribbean or African (2.0%).
Source: Psychiatric Census collection, Welsh Government
[Note 1] 21% of records had missing or undisclosed ethnicity data.
A similar proportion of resident patients were from White, Mixed/Multiple or Other ethnic groups compared to the general population, according to the Census 2021 (ONS). Whilst over double the expected proportion of patients were from the Black/Black British/Caribbean or African ethnic group compared to the general population. The Asian/Asian British ethnic group had a lower proportion of patients compared to the general population.
Patients in mental health hospitals and units for people with a learning disability
Learning disability data is based on small numbers of patients; therefore, can be volatile from year to year, more emphasis should be placed on longer term trends.
Method of admission
Figure 7: Number of resident patients in mental health hospitals and units with a learning disability by method of admission at 31 March, 2015 to 2024
Description of Figure 7: Line chart showing that the total number and formal number of learning disability resident patients has decreased over the last 10 years whilst the informal number has remained stable.
Source: Psychiatric Census collection, Welsh Government
[Note 1] Due to the COVID-19 pandemic the psychiatric census was suspended for 2020, therefore no data is available.
At 31 March 2024 there were 69 resident patients with a learning disability, an increase of 3 (5%) from 2023 but 56 (45%) less than 2015.
Just over half, 52%, (36) of these were informal patients (2024 marked the lowest percentage ever recorded) whilst 48% (33) were formal patients. This contrasts with 10 years ago when 75% of patients were informal and 25% formal.
Overall, the number of informal patients has decreased by 58 from 94 in 2015 to 36 in 2024, a decrease of 62%. In contrast the number of patients formally detained has stayed relatively the same in the last 10 years, ranging from 20 in 2018 to 33 in 2024.
64% of formally detained patients were male with 36% female and 61% of informal resident patients were male with 39% female.
Only 4 local health boards (LHB) had learning disability resident patients on 31 March 2024. As in previous years Swansea Bay had the majority of these 40 (58%), split between 7 hospitals. The only other LHBs to have learning disability resident patients was Betsi Cadwaladr (15), Aneurin Bevan (11) and Hywel Dda (3). 22% of all resident patients with a learning disability were accommodated at Bryn-y-Neuadd Hospital in Betsi Cadwaladr (15 of 69).
Length of stay
Figure 8: Number of resident patients in mental health hospitals and units with a learning disability by length of stay at 31 March, 2015 to 2024
Description of Figure 8: Line chart showing most resident patients duration of stay was 3 months to under 2 years in the previous 3 years. Prior to that 2 years and over was the most common, but this group has seen a large decline.
Source: Psychiatric Census collection, Welsh Government
[Note 1] Due to the COVID-19 pandemic the psychiatric census was suspended for 2020, therefore no data is available.
In the last 10 years the number of resident patients with a duration of stay of 2 years or over fell from 80 in 2015 to 29 in 2024, a decrease of 64%. This was largely driven by patients who had a duration of stay of 10 years and over, which fell from 42 in 2015 to 10 in 2024, a decrease of 76%.
At 31 March 2024, 42% of patients had a duration of stay of 2 years or more compared with 64% in 2015. This 42% for learning disability patients with a stay 2 years or over compares to just 8% of mental illness patients in 2024.
Male patients with a stay 2 years and over fell from 56 in 2015 to 17 in 2024, a decrease of 70%, this includes an 85% decrease from 34 to 5 when the stay was 10 years or over. Similarly, female patients with a stay 2 years or over fell from 24 in 2015 to 12 in 2024, a decrease of 50%.
Characteristics of patients
Figure 9: Number of resident patients in mental health hospitals and units with a learning disability by sex at 31 March, 2015 to 2024
Description of Figure 9: Line chart showing that the number of male and female resident patients has decreased over the last 10 years, but there has been consistently more male than female residents each year.
Source: Psychiatric Census collection, Welsh Government
[Note 1] Due to the COVID-19 pandemic the psychiatric census was suspended for 2020, therefore no data is available.
At 31 March 2024 of the 69 resident patients with a learning disability, there were 43 male patients down 48% from 83 in 2015, compared with 26 females down 38% from 42 in 2015. The 2024 total of female patients (26) was the highest since 2018.
62% of patients were male compared with 38% female, continuing the trend of more males than females in each of the last 10 years.
Figure 10: Number of resident patients in mental health hospitals and units with a learning disability by age group at 31 March, 2015 to 2024
Description of Figure 10: Line chart showing the majority of resident patients were found in the 45-64 age group which has been the case over the last decade.
Source: Psychiatric Census collection, Welsh Government
[Note 1] Due to the COVID-19 pandemic the psychiatric census was suspended for 2020, therefore no data is available.
In the last 10 years all age groups have seen a decrease in numbers, with the exception of the under 25 age group which has stayed fairly constant.
At 31 March the number of resident patients aged 65 and over fell from 15 in 2015 to 7 in 2024, a decrease of 53%. Similarly, the 25 to 44 and 45 to 64 age groups have decreased by 48% (40 to 21) and 47% (60 to 32) respectively.
In 2024, 13% of patients were under 25 years old; 30% were 25 to 44 years old; 46% were 45 to 64 years old and 10% were 65 years or older.
When looking by age group and sex, on 31 March 2024, the number of patients is similar in the under 25 and 65 and over age groups but the male total is roughly double the female total for the 25 to 44 and 45 to 64 age groups.
All learning disability patients recorded were in the White ethnic group. 4% of records had missing or undisclosed ethnicity data.
Quality and methodology information
The census is taken at midnight on 31 March each year and covers patients in NHS mental health hospitals and mental health units in NHS hospitals in Wales which may have other specialties. Mental health hospitals and units include those patients with a learning disability as well as those with a mental illness. It does not include Welsh residents who are patients at hospitals in England but can include patients who are resident in England.
Comparability
There is similar information available from other parts of the UK but the data is not exactly comparable due to local definitions and standards in each area.
England
Mental Health Data Hub (NHS Digital)
Scotland
Learning disability inpatient activity (Public Health Scotland)
Northern Ireland
Mental Health & Learning Disability (Department of Health)
Statement of compliance with the Code of Practice for Statistics
Our statistical practice is regulated by the Office for Statistics Regulation (OSR). OSR sets the standards of trustworthiness, quality and value in the Code of Practice for Statistics that all producers of official statistics should adhere to.
All of our statistics are produced and published in accordance with a number of statements and protocols to enhance trustworthiness, quality and value. These are set out in the Welsh Government’s Statement of Compliance.
These official statistics demonstrate the standards expected around trustworthiness, quality, and public value in the following ways.
Trustworthiness
The main source of information is the annual Psychiatric Census data collection which is collected from individual local health boards by Digital Health and Care Wales (DHCW) and are subject to validation checks centrally prior to publication.
For the data on 31 March 2013 onwards, further checks were introduced by DHCW to eliminate duplicate records. This has not been applied to historic data as the impact is expected to be minimal. It is the responsibility of local health boards to ensure that the figures have been compiled correctly in accordance with central definitions and guidelines.
In tables where figures have been rounded to the nearest final digit there may be an apparent discrepancy between the sum of the constituent items and the total as shown.
The data collections are overseen by the Welsh Information Standards Board (WISB), which is the custodian of the Information Standards Assurance Process. WISB mandates data collections through the NHS and local heath boards, appraises information standards and provides assurance on matters related to confidentiality and consent.
These statistics are pre-announced on the Statistics and Research Upcoming calendar. Access to the data during processing is restricted to those involved in the production of the statistics, quality assurance and for operational purposes. Pre-release access is restricted to eligible recipients in line with the Code of Practice (UK Statistics Authority).
In the unlikely event of incorrect data being published revisions to data would be made and users informed in conjunction with our revisions, errors and postponements arrangements.
Notes inform the users whether the outputs have been revised or not (denoted r). We will also give an indication of the size of the revision between the latest and previous release. There are not generally revisions to the data. However, if there are revisions they generally only take place when we receive a resubmission from the local health board for previous years’ data and the revisions will be published at the same time as the most recent year’s data.
Quality
Statistics published by Welsh Government adhere to the Statistical Quality Management Strategy which supplements the Quality pillar of the Code of Practice for Statistics and the European Statistical System principles of quality for statistical outputs.
Data are collected by financial year and are subject to validation checks performed by Welsh Government statisticians and queries referred to local health boards where necessary prior to publication. However, it is the responsibility of these organisations to ensure that the figures have been compiled correctly in accordance with central definitions and guidelines.
Agreed standards and definitions within Wales provide assurance that the data is consistent across local health boards. Every year the data are collected from the same sources and adhere to the national standard, meaning that they should be coherent within and across organisations.
The statistical release is then drafted and quality assured by senior statisticians and published in line with the Code of Practice for Statistics (UK Statistics Authority).
We aim to use Plain English in our outputs and all outputs adhere to the Welsh Government accessibility policy. Furthermore, all our headlines are published in Welsh and English.
Definitions of terms used can be found in the NHS Wales Data Dictionary.
Value
The statistics are important and have a number of uses, for example: advice to Ministers; NHS Wales; media; informing the debate in the Welsh Parliament and beyond; assisting in research in mental health issues; economic analysis.
Furthermore, these statistics enable service providers such as Local Health Boards to monitor their own performance.
More detailed data are also available at the same time on the StatsWales website and this can be manipulated online or downloaded into spreadsheets for use offline.
The information published here also supports the Welsh Government’s long-term plan for health and social care: A Healthier Wales.
The timeliness of the data provides the most recent update using reliable data.
You are welcome to contact us directly with any comments about how we meet these standards. Alternatively, you can contact OSR by emailing regulation@statistics.gov.uk or via the OSR website.
Well-being of Future Generations Act (WFG)
The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators (“national indicators”) that must be applied for the purpose of measuring progress towards the achievement of the wellbeing goals, and (b) lay a copy of the national indicators before Senedd Cymru. Under section 10(8) of the Well-being of Future Generations Act, where the Welsh Ministers revise the national indicators, they must as soon as reasonably practicable (a) publish the indicators as revised and (b) lay a copy of them before the Senedd. These national indicators were laid before the Senedd in 2021. The indicators laid on 14 December 2021 replace the set laid on 16 March 2016.
Information on the indicators, along with narratives for each of the wellbeing goals and associated technical information is available in the Wellbeing of Wales report.
Further information on the Well-being of Future Generations (Wales) Act 2015.
The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local wellbeing assessments and local wellbeing plans.
We want your feedback
We welcome any feedback on any aspect of these statistics which can be provided by email to stats.healthinfo@gov.wales.