Severe Mental Illness

Introduction

The Severe Mental Illness Profiling tool is part of a suite that make population level data on mental health publicly available, and supports an intelligence driven approach to understanding and meeting need.

The tool collates and analyses a wide range of data on prevalence, risk, prevention, early intervention, assessment, treatment, outcomes and inequality. It provides commissioners, service providers, clinicians, services users and their families with the means to profile areas and benchmark against similar populations.

Note: data are drawn from many sources and vary by time period, population and presentation of values. Care should be taken with interpretation. Detailed meta data and any caveats are set out in the Definitions section.

Significant updates

April 2021 - an Exploring Inequality domain has been added to this profiling tool. It includes metrics that can be further broken down by population characteristic and by deprivation grouping.

Go to Exploring Inequality for an introduction on content and using this new domain.

To go direct to the available metrics click on Inequality in detail

December 2020 - 2 new indicators on mortality in adults with SMI have been added. These are:

premature mortality in adults with SMI
excess under 75 mortality rate in adults with SMI

and can be found in Quality and Outcomes domain, for area County and UA pre 4/19

Supporting documents

Indicator list SMI profile: tool content at a glance

Recent updates

July 2023

The following indicators were updated:

Quality and outcomes

Smoking prevalence in adults with a long term mental health condition (18+) - current smokers (GPPS)

February 2023

The following indicators were updated:

Risk and related factors

Domestic abuse related incidents and crimes

Quality and outcomes

Adults in contact with secondary mental health services who live in stable and appropriate accommodation
Gap in the employment rate for those who are in contact with secondary mental health services (age 18 and 69) and on the Care Plan Approach, and the overall employment rate
Homelessness: households in temporary accommodation
Homelessness: households owed a duty under the Homelessness Reduction Act

Premature mortality and excess premature mortality indicators

For 2018-2020, an error has been identified with the data in the publication of the premature mortality and excess premature mortality indicators. This error relates to data for Northamptonshire UTLA and subsequently the data for the East Midlands region. The Northamptonshire UTLA underwent changes in the 3 year period which were not previously accounted for. This has been rectified and will be updated on Fingertips in the March update. Changes at region level are not significant however the changes at UTLA level for Northamptonshire are significant. Additionally, a small number of deaths in the South East region were not mapped previously, these have been added causing a small change in the South East region data
For 2017-2019, an error has been identified with the data in the publication of the premature mortality and excess premature mortality indicators. This error relates to data for Buckinghamshire UTLA and subsequently the the data for the South East region. The Buckinghamshire UTLA underwent changes in the 3 year period which were not previously accounted for. This has been rectified and will be updated on Fingertips in the March update. Changes are at region level are not significant however the changes at UTLA level for Buckinghamshire are significant.

December 2022

The following indicators were updated:

Psychosis Pathway

Mental Health: QOF prevalence (all ages)

Risk and related factors

Learning disability: QOF prevalence (all ages)

Quality and outcomes

Patients with severe mental health issues having a comprehensive care plan (denominator incl. PCAs)
Record of a BP check in the last 12 months for patients on the MH register (denominator incl. PCAs)
Smoking cassation support and treatment offered to patients with certain conditions (denominator incl. PCAs)

October 2022

The following indicators were also updated:

Risk and related factors domain:

Violent crime - violence offences per 1,000 population

Quality and outcomes domain:

Suicide rate

August 2022

Quality and outcomes domain:

Gap in the employment rate for those who are in contact with secondary mental health services (aged 18 to 69) and on the Care Plan Approach, and the overall employment rate

May 2022

Indicators on Premature mortality in adults with SMI and Excess under 75 mortality rate in adults with SMI were updated to include:

condition-specific premature mortality and excess premature mortality for people with SMI indicators for the periods 2017-2019 and 2018 -2020 for England, regions and upper tier local authorities
publication of additional breakdowns for the premature mortality and excess premature mortality for people with SMI indicators for the periods 2015-2017, 2016-2018, 2017-2019 and 2018-2020 for England

Error Correction: Due to error in data published by NHS Digital this update also includes correction of all causes excess premature mortality for people with SMI indicators for the periods 2017-2019 and 2018-2020 for England, regions and upper tier local authorities.

Risk and related factors domain:

Long term claimants of Jobseeker's Allowance

Quality and outcomes domain:

Smoking prevalence in adults with a long term mental health condition (18+) - current smokers (GPPS)

April 2022

The following Indicators within the ‘Services’ and ‘Exploring Inequalities’ domains were updated with 2019/20 data. The historical data for 2017/18 and 2018/19 were also updated to reflect the more up to date geographical boundaries.

Attended contacts with community and outpatient mental health services, per 100,000 (all ages)
New referrals to secondary mental health services, per 100,000 (all ages)
Inpatient stays in secondary mental health services, per 100,000 (all ages)

The following indicators were also updated:

Risk and related factors domain:

Domestic abuse-related incidents and crimes

Quality and outcomes domain:

Patients with severe mental health issues having a comprehensive care plan (denominator includes PCAs)
MH003: record of blood pressure check in preceding 12 months for patients on the MH register (denominator includes PCAs)
Smoking cessation support and treatment offered to patients with certain conditions (denominator incl. PCAs)
Adult in contact with secondary mental health services who live in stable and appropriate accommodation

Exploring Inequality domain:

Emergency Hospital Admission for International Self-Harm

December 2021

Indicators on Premature mortality in adults with severe mental illness (SMI) and Excess under 75 mortality rate in adults with severe mental illness (SMI) were updated for 2017-19 and 2018-20. Breakdown by gender is also available.

The following indicators were also updated:

Prevalence domain:

Mental Health: QOF prevalence (all ages)

Risk and related factors domain:

Learning disability: QOF prevalence
Violent crime - violence offences per 1,000 population

Quality and outcomes domain:

Personalised Care Adjustment (PCA) rate for MH indicators
MH003: record of blood pressure check in preceding 12 months for patients on the MH register (denominator includes PCAs)
MH003: record of blood pressure check in preceding 12 months for patients on the MH register (denominator includes PCAs)
Premature mortality in adults with severe mental illness (SMI)
Excess under 75 mortality rate in adults with severe mental illness (SMI)

August 2021

Quality and Outcomes domain

The following indicators were updated:

Premature mortality in adults with severe mental illness (SMI)
Excess premature mortality in adults with severe mental illness (SMI)

Please note: Data for 2015-17 have been recalculated due to a change in the methodology for assignment of patient ID by NHS Digital across a number of datasets. Please see metadata for further information.

The following new indicators were added:

Premature mortality due to cancer in adults with severe mental illness (SMI)
Premature mortality due to cardiovascular diseases in adults with severe mental illness (SMI)
Premature mortality due to liver disease in adults with severe mental illness (SMI)
Premature mortality due to respiratory disease in adults with severe mental illness (SMI)
Excess under 75 mortality rate due to cancer in adults with severe mental illness (SMI)
Excess under 75 mortality rate due to cardiovascular disease in adults with severe mental illness (SMI)
Excess under 75 mortality rate due to liver disease in adults with severe mental illness (SMI)
Excess under 75 mortality rate due to respiratory disease in adults with severe mental illness (SMI)

April 2021

Exploring Inequality: Learn more about inequality data in secondary mental health services data.

Inequality in detail Examine the range of inequality data in our indicators

The following new indicators have been added:

New referrals to secondary mental health services
Attended contacts with community and outpatient mental health services
Inpatient stays in secondary mental health services

The following indicators have been updated:

Domestic abuse-related incidents and crimes
Emergency Hospital Admissions for Intentional Self-Harm
Learning disability: QOF prevalence
Mental Health: QOF prevalence
MH002: comprehensive care plan
MH003: record of blood pressure check in preceding 12 months for patients on the MH register
Personalised Care Adjustment (PCA) rate for MH indicators
SMOK005: cessation support and treatment offered (certain conditions)
Smoking prevalence in adults with a long term mental health condition (18+) - current smokers (GPPS)
Suicide rate
Violent crime - violence offences per 1,000 population

March 2021

Two small errors have been found in the contextual data published by NHS Digital for the following indicator:

Excess premature mortality in adults with severe mental illness (SMI)

Details of the errors and corrected data is now available from the NHS Outcome Framework website

This only affected the version of the data published by NHS Digital and data on this site was not affected

December 2020

The following indicators were added:

Quality and Outcomes domain

Premature mortality in adults with severe mental illness (SMI)
Excess premature mortality in adults with severe mental illness (SMI)
Smoking prevalence in adults with a long term mental health condition (18+) – current smokers (GPPS)

The following indicators were removed:

Psychosis Pathway domain

People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)

Prevalence domain

Ratio of QOF and estimated prevalence of severe mental illness (SMI): QOF register prevalence of SMI as a ratio of estimated prevalence of SMI

Services domain

BME mental health service users: % of mental health service users
People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)

Quality and Outcomes domain

Excess under 75 mortality rate in adults with severe mental illness (SMI)
Recording of employment status: % of people in contact with mental health and learning disability services with employment status recorded (end of quarter snapshot)
Recording of accommodation status: Percentage of people in contact with mental health services with accommodation status recorded (end of quarter snapshot)
Smoking prevalence in adults (18+) with serious mental illness (SMI)

August 2020

The following indicators have been removed:

Services domain

Adult acute mental health admissions: rate per 100,000 population aged 16-64
Adult acute mental health bed days: rate per 100,000 population aged 16-64
Older adult mental health admissions: rate per 100,000 population aged 65+
Older adult mental health bed days: rate per 100,000 population aged 65+
Contacts with Community Mental Health Teams: rate per 100,000 population aged 16+
Referrals received by Community Mental Health Teams: rate per 100,000 population aged 16+
Referrals received by Crisis Resolution and Home Treatment: rate per 100,000 population aged 16-64
Contacts delivered by Crisis Resolution and Home Treatment: rate per 100,000 population aged 16-64
Acute adult mental health beds: rate per 100,000 population aged 16-64
Community Mental Health Team caseload: rate per 100,000 population aged 16+ (snapshot)
Referrals accepted by Community Mental Health Teams: % of all referrals

Quality and Outcomes domain

Serious incidents: rate per 100,000 occupied bed days
Medication Incidents: rate per 100,000 occupied bed days
Use of restraint: rate per 100,000 occupied bed days
Complaints: rate per 100,000 occupied bed days
Adult acute readmissions: % readmissions within 30 days
Older adult readmissions: % readmissions within 30 days
Adult acute bed days lost to DTOC: % of bed days
Older adult bed days lost to DTOC: % of bed days
CMHT contacts which are face to face: % of all contacts
CRHT response: % of CRHT requests with response within 24 hours

January 2020

Thirty two indicators in Profile have been updated.

Seven indicators in the Psychosis pathways domain.
Two indicators in the Risk factors domain.
One indicator in the Prevalence domain.
Two indicators in the Services domain.
Twenty indicators in the Qualities and Outcomes domain
September 2019

Four indicators in the quality and outcomes domain.
- Experience of access and waiting: overall patient experience score
- Experience of safe, high quality, co-ordinated care: overall patient experience score
- Experience of better information, more choice: overall patient experience score
- Experience of building closer relationships: overall patient experience score
Aug 2019

Two indicators in the quality and outcomes domain.
- Gate kept admissions: % (quarterly) admissions to acute wards that were gate kept by the CRHT teams
- Follow up after discharge: % (quarterly) of patients on CPA
- Delayed transfers of care due to NHS: Delayed Transfers of Care per 1,000 bed days
- Delayed transfers of care due to social care: Delayed Transfers of Care per 1,000 bed days
July 2019

Indicator 93291 persons detained under Mental Heath Act is now also available for older persons (people over 65 + years)

17 Quarterly indicators updated with the latest MHSDS data for Q4 2017/18

Quality and Outcomes
- CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot)
- Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot)
- CPA review: % of people on CPA for more than 12 months who have had a review (end of quarter snapshot)
- CPA users with HoNOS assessment: % of people on CPA with HoNOS recorded (end of quarter snapshot)
- Recording of employment status: % of people in contact with mental health and learning disability services with employment status recorded (end of quarter snapshot)
- Diagnosis coding: % of people in contact with mental health services with a diagnosis or provisional diagnosis recorded (end of quarter snapshot)
- Recording of accommodation status: Percentage of people in contact with mental health services with accommodation status recorded (end of quarter snapshot)
- Delayed discharges: days of delayed discharges in the quarter: rate per 1,000 bed days
- Service users with crisis plans: % of people in contact with mental health services (end of quarter snapshot)
Services
- People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)
- People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot)
- Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot)
- Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot)
- Service users in hospital: % of mental health service users (end of quarter snapshot)
- Mental health admissions to hospital: rate per 100,000 population
- Persons detained under MHA: proportion of people in contact with mental health services (end of quarter snapshot)
- Persons detained under MHA: rate per 100,000 population (end of quarter snapshot)
June 2019

RAG rating for all serious mental illness indicators has been added to align with other PHE indicators in fingertips.

17 Quarterly indicators updated

Quality and Outcomes
- CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot)
- Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot)
- CPA review: % of people on CPA for more than 12 months who have had a review (end of quarter snapshot)
- CPA users with HoNOS assessment: % of people on CPA with HoNOS recorded (end of quarter snapshot)
- Recording of employment status: % of people in contact with mental health and learning disability services with employment status recorded (end of quarter snapshot)
- Diagnosis coding: % of people in contact with mental health services with a diagnosis or provisional diagnosis recorded (end of quarter snapshot)
- Recording of accommodation status: Percentage of people in contact with mental health services with accommodation status recorded (end of quarter snapshot)
- Delayed discharges: days of delayed discharges in the quarter: rate per 1,000 bed days
- Service users with crisis plans: % of people in contact with mental health services (end of quarter snapshot)
Services
- People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)
- People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot)
- Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot)
- Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot)
- Service users in hospital: % of mental health service users (end of quarter snapshot)
- Mental health admissions to hospital: rate per 100,000 population
- Persons detained under MHA: proportion of people in contact with mental health services (end of quarter snapshot)
- Persons detained under MHA: rate per 100,000 population (end of quarter snapshot)
January 2019

Updates 17 indicators updated

Quality and Outcomes
- CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot)
- Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot)
- CPA review: % of people on CPA for more than 12 months who have had a review (end of quarter snapshot)
- CPA users with HoNOS assessment: % of people on CPA with HoNOS recorded (end of quarter snapshot)
- Recording of employment status: % of people in contact with mental health and learning disability services with employment status recorded (end of quarter snapshot)
- Diagnosis coding: % of people in contact with mental health services with a diagnosis or provisional diagnosis recorded (end of quarter snapshot)
- Recording of accommodation status: Percentage of people in contact with mental health services with accommodation status recorded (end of quarter snapshot)
- Delayed discharges: days of delayed discharges in the quarter: rate per 1,000 bed days
- Service users with crisis plans: % of people in contact with mental health services (end of quarter snapshot)
Services
- People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)
- People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot)
- Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot)
- Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot)
- Service users in hospital: % of mental health service users (end of quarter snapshot)
- Mental health admissions to hospital: rate per 100,000 population
- Persons detained under MHA: proportion of people in contact with mental health services (end of quarter snapshot)
- Persons detained under MHA: rate per 100,000 population (end of quarter snapshot)
  
  December 2018
  
  27 new indicators updated using the latest MHSDS and QOF data
  
  Psychosis Pathway
  
  •Severe mental illness recorded prevalence (QOF): % of practice register (all ages)
  
  Risk and related factors
  
  •Learning disability QOF prevalence: % of people on GP practice registers
  
  Services
  
  •Contact with specialist mental health services: rate per 100,000 population aged 18+
  
  •People on Care Programme Approach (CPA): rate per 100,000 population aged 18+
  
  •Mental health admissions to hospital: rate per 100,000 population
  
  •People subject to Mental Health Act: rate per 100,000 population aged 18+
  
  •Persons detained under MHA: rate per 100,000 population
  
  •CPA users with HoNOS assessment: % of people on CPA with HoNOS recorded
  
  •Mental health service users on Care Programme Approach: % of mental health service users
  
  •Service users in hospital: % of mental health service users
  
  Quality and outcomes
  
  •CPA adults in employment: % of people on CPA (aged 18-69)
  
  •Persons detained under MHA: proportion of people in contact with mental health services Stable and appropriate accommodation: % of people on CPA (aged 18-69)
  
  •Delayed discharges: days of delayed discharges in the quarter: rate per 1,000 bed days
  
  •Recording of employment status: % of people in contact with mental health and learning disability services with employment status recorded
  
  •Diagnosis coding: % of people in contact with mental health services with a diagnosis or provisional diagnosis recorded
  
  •Recording of accommodation status: Percentage of people in contact with mental health services with accommodation status recorded
  
  •Service users with crisis plans: % of people in contact with mental health services
  
  •People with SMI who have comprehensive care plan: % of people with SMI
  
  •Patients on lithium therapy with record of serum creatinine and TSH: % with record in the preceding 9 months
  
  •Patients on lithium therapy with levels in therapeutic range: % within preceding 4 months
  
  •Exception rate for severe mental illness (SMI) QOF indicators: % of patients excluded from mental health quality indicators
  
  •Patients with SMI with alcohol consumption check: % with record in preceding 12 months
  
  •Female patients with SMI who had cervical screening test: % tested in preceding 5 years
  
  •Smokers on GP registers (certain conditions) offered cessation support and treatment: % within preceding 12 months
  
  •Staff training: % of staff receiving job-relevant training, learning or development in last 12 months
  
  •Staff health & safety training: % of staff receiving mandatory training in last 12 months
  
  •Staff witnessing potentially harmful errors, near misses or incidents: % staff witnessing in last month
  
  •Staff engagement: overall score

Recent updates

July 2023

The following indicators were updated:

Quality and outcomes

Smoking prevalence in adults with a long term mental health condition (18+) - current smokers (GPPS)

February 2023

The following indicators were updated:

Risk and related factors

Domestic abuse related incidents and crimes

Quality and outcomes

Adults in contact with secondary mental health services who live in stable and appropriate accommodation
Gap in the employment rate for those who are in contact with secondary mental health services (age 18 and 69) and on the Care Plan Approach, and the overall employment rate
Homelessness: households in temporary accommodation
Homelessness: households owed a duty under the Homelessness Reduction Act

Premature mortality and excess premature mortality indicators

For 2018-2020, an error has been identified with the data in the publication of the premature mortality and excess premature mortality indicators. This error relates to data for Northamptonshire UTLA and subsequently the data for the East Midlands region. The Northamptonshire UTLA underwent changes in the 3 year period which were not previously accounted for. This has been rectified and will be updated on Fingertips in the March update. Changes at region level are not significant however the changes at UTLA level for Northamptonshire are significant. Additionally, a small number of deaths in the South East region were not mapped previously, these have been added causing a small change in the South East region data
For 2017-2019, an error has been identified with the data in the publication of the premature mortality and excess premature mortality indicators. This error relates to data for Buckinghamshire UTLA and subsequently the the data for the South East region. The Buckinghamshire UTLA underwent changes in the 3 year period which were not previously accounted for. This has been rectified and will be updated on Fingertips in the March update. Changes are at region level are not significant however the changes at UTLA level for Buckinghamshire are significant.

December 2022

The following indicators were updated:

Psychosis Pathway

Mental Health: QOF prevalence (all ages)

Risk and related factors

Learning disability: QOF prevalence (all ages)

Quality and outcomes

Patients with severe mental health issues having a comprehensive care plan (denominator incl. PCAs)
Record of a BP check in the last 12 months for patients on the MH register (denominator incl. PCAs)
Smoking cassation support and treatment offered to patients with certain conditions (denominator incl. PCAs)

October 2022

The following indicators were also updated:

Risk and related factors domain:

Violent crime - violence offences per 1,000 population

Quality and outcomes domain:

Suicide rate

August 2022

Quality and outcomes domain:

Gap in the employment rate for those who are in contact with secondary mental health services (aged 18 to 69) and on the Care Plan Approach, and the overall employment rate

May 2022

Indicators on Premature mortality in adults with SMI and Excess under 75 mortality rate in adults with SMI were updated to include:

condition-specific premature mortality and excess premature mortality for people with SMI indicators for the periods 2017-2019 and 2018 -2020 for England, regions and upper tier local authorities
publication of additional breakdowns for the premature mortality and excess premature mortality for people with SMI indicators for the periods 2015-2017, 2016-2018, 2017-2019 and 2018-2020 for England

Risk and related factors domain:

Long term claimants of Jobseeker's Allowance

Quality and outcomes domain:

Smoking prevalence in adults with a long term mental health condition (18+) - current smokers (GPPS)

April 2022

Attended contacts with community and outpatient mental health services, per 100,000 (all ages)
New referrals to secondary mental health services, per 100,000 (all ages)
Inpatient stays in secondary mental health services, per 100,000 (all ages)

The following indicators were also updated:

Risk and related factors domain:

Domestic abuse-related incidents and crimes

Quality and outcomes domain:

Patients with severe mental health issues having a comprehensive care plan (denominator includes PCAs)
MH003: record of blood pressure check in preceding 12 months for patients on the MH register (denominator includes PCAs)
Smoking cessation support and treatment offered to patients with certain conditions (denominator incl. PCAs)
Adult in contact with secondary mental health services who live in stable and appropriate accommodation

Exploring Inequality domain:

Emergency Hospital Admission for International Self-Harm

December 2021

The following indicators were also updated:

Prevalence domain:

Mental Health: QOF prevalence (all ages)

Risk and related factors domain:

Learning disability: QOF prevalence
Violent crime - violence offences per 1,000 population

Quality and outcomes domain:

Personalised Care Adjustment (PCA) rate for MH indicators
MH003: record of blood pressure check in preceding 12 months for patients on the MH register (denominator includes PCAs)
MH003: record of blood pressure check in preceding 12 months for patients on the MH register (denominator includes PCAs)
Premature mortality in adults with severe mental illness (SMI)
Excess under 75 mortality rate in adults with severe mental illness (SMI)

August 2021

Quality and Outcomes domain

The following indicators were updated:

Premature mortality in adults with severe mental illness (SMI)
Excess premature mortality in adults with severe mental illness (SMI)

The following new indicators were added:

Premature mortality due to cancer in adults with severe mental illness (SMI)
Premature mortality due to cardiovascular diseases in adults with severe mental illness (SMI)
Premature mortality due to liver disease in adults with severe mental illness (SMI)
Premature mortality due to respiratory disease in adults with severe mental illness (SMI)
Excess under 75 mortality rate due to cancer in adults with severe mental illness (SMI)
Excess under 75 mortality rate due to cardiovascular disease in adults with severe mental illness (SMI)
Excess under 75 mortality rate due to liver disease in adults with severe mental illness (SMI)
Excess under 75 mortality rate due to respiratory disease in adults with severe mental illness (SMI)

April 2021

Exploring Inequality: Learn more about inequality data in secondary mental health services data.

Inequality in detail Examine the range of inequality data in our indicators

The following new indicators have been added:

New referrals to secondary mental health services
Attended contacts with community and outpatient mental health services
Inpatient stays in secondary mental health services

The following indicators have been updated:

Domestic abuse-related incidents and crimes
Emergency Hospital Admissions for Intentional Self-Harm
Learning disability: QOF prevalence
Mental Health: QOF prevalence
MH002: comprehensive care plan
MH003: record of blood pressure check in preceding 12 months for patients on the MH register
Personalised Care Adjustment (PCA) rate for MH indicators
SMOK005: cessation support and treatment offered (certain conditions)
Smoking prevalence in adults with a long term mental health condition (18+) - current smokers (GPPS)
Suicide rate
Violent crime - violence offences per 1,000 population

March 2021

Two small errors have been found in the contextual data published by NHS Digital for the following indicator:

Excess premature mortality in adults with severe mental illness (SMI)

Details of the errors and corrected data is now available from the NHS Outcome Framework website

This only affected the version of the data published by NHS Digital and data on this site was not affected

December 2020

The following indicators were added:

Quality and Outcomes domain

Premature mortality in adults with severe mental illness (SMI)
Excess premature mortality in adults with severe mental illness (SMI)
Smoking prevalence in adults with a long term mental health condition (18+) – current smokers (GPPS)

The following indicators were removed:

Psychosis Pathway domain

People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)

Prevalence domain

Ratio of QOF and estimated prevalence of severe mental illness (SMI): QOF register prevalence of SMI as a ratio of estimated prevalence of SMI

Services domain

BME mental health service users: % of mental health service users
People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)

Quality and Outcomes domain

Excess under 75 mortality rate in adults with severe mental illness (SMI)
Recording of employment status: % of people in contact with mental health and learning disability services with employment status recorded (end of quarter snapshot)
Recording of accommodation status: Percentage of people in contact with mental health services with accommodation status recorded (end of quarter snapshot)
Smoking prevalence in adults (18+) with serious mental illness (SMI)

August 2020

The following indicators have been removed:

Services domain

Adult acute mental health admissions: rate per 100,000 population aged 16-64
Adult acute mental health bed days: rate per 100,000 population aged 16-64
Older adult mental health admissions: rate per 100,000 population aged 65+
Older adult mental health bed days: rate per 100,000 population aged 65+
Contacts with Community Mental Health Teams: rate per 100,000 population aged 16+
Referrals received by Community Mental Health Teams: rate per 100,000 population aged 16+
Referrals received by Crisis Resolution and Home Treatment: rate per 100,000 population aged 16-64
Contacts delivered by Crisis Resolution and Home Treatment: rate per 100,000 population aged 16-64
Acute adult mental health beds: rate per 100,000 population aged 16-64
Community Mental Health Team caseload: rate per 100,000 population aged 16+ (snapshot)
Referrals accepted by Community Mental Health Teams: % of all referrals

Quality and Outcomes domain

Serious incidents: rate per 100,000 occupied bed days
Medication Incidents: rate per 100,000 occupied bed days
Use of restraint: rate per 100,000 occupied bed days
Complaints: rate per 100,000 occupied bed days
Adult acute readmissions: % readmissions within 30 days
Older adult readmissions: % readmissions within 30 days
Adult acute bed days lost to DTOC: % of bed days
Older adult bed days lost to DTOC: % of bed days
CMHT contacts which are face to face: % of all contacts
CRHT response: % of CRHT requests with response within 24 hours

January 2020

Thirty two indicators in Profile have been updated.

Seven indicators in the Psychosis pathways domain.
Two indicators in the Risk factors domain.
One indicator in the Prevalence domain.
Two indicators in the Services domain.
Twenty indicators in the Qualities and Outcomes domain
September 2019

Four indicators in the quality and outcomes domain.
- Experience of access and waiting: overall patient experience score
- Experience of safe, high quality, co-ordinated care: overall patient experience score
- Experience of better information, more choice: overall patient experience score
- Experience of building closer relationships: overall patient experience score
Aug 2019

Two indicators in the quality and outcomes domain.
- Gate kept admissions: % (quarterly) admissions to acute wards that were gate kept by the CRHT teams
- Follow up after discharge: % (quarterly) of patients on CPA
- Delayed transfers of care due to NHS: Delayed Transfers of Care per 1,000 bed days
- Delayed transfers of care due to social care: Delayed Transfers of Care per 1,000 bed days
July 2019

Indicator 93291 persons detained under Mental Heath Act is now also available for older persons (people over 65 + years)

17 Quarterly indicators updated with the latest MHSDS data for Q4 2017/18

Quality and Outcomes
- CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot)
- Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot)
- CPA review: % of people on CPA for more than 12 months who have had a review (end of quarter snapshot)
- CPA users with HoNOS assessment: % of people on CPA with HoNOS recorded (end of quarter snapshot)
- Recording of employment status: % of people in contact with mental health and learning disability services with employment status recorded (end of quarter snapshot)
- Diagnosis coding: % of people in contact with mental health services with a diagnosis or provisional diagnosis recorded (end of quarter snapshot)
- Recording of accommodation status: Percentage of people in contact with mental health services with accommodation status recorded (end of quarter snapshot)
- Delayed discharges: days of delayed discharges in the quarter: rate per 1,000 bed days
- Service users with crisis plans: % of people in contact with mental health services (end of quarter snapshot)
Services
- People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)
- People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot)
- Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot)
- Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot)
- Service users in hospital: % of mental health service users (end of quarter snapshot)
- Mental health admissions to hospital: rate per 100,000 population
- Persons detained under MHA: proportion of people in contact with mental health services (end of quarter snapshot)
- Persons detained under MHA: rate per 100,000 population (end of quarter snapshot)
June 2019

RAG rating for all serious mental illness indicators has been added to align with other PHE indicators in fingertips.

17 Quarterly indicators updated

Quality and Outcomes
- CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot)
- Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot)
- CPA review: % of people on CPA for more than 12 months who have had a review (end of quarter snapshot)
- CPA users with HoNOS assessment: % of people on CPA with HoNOS recorded (end of quarter snapshot)
- Recording of employment status: % of people in contact with mental health and learning disability services with employment status recorded (end of quarter snapshot)
- Diagnosis coding: % of people in contact with mental health services with a diagnosis or provisional diagnosis recorded (end of quarter snapshot)
- Recording of accommodation status: Percentage of people in contact with mental health services with accommodation status recorded (end of quarter snapshot)
- Delayed discharges: days of delayed discharges in the quarter: rate per 1,000 bed days
- Service users with crisis plans: % of people in contact with mental health services (end of quarter snapshot)
Services
- People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)
- People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot)
- Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot)
- Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot)
- Service users in hospital: % of mental health service users (end of quarter snapshot)
- Mental health admissions to hospital: rate per 100,000 population
- Persons detained under MHA: proportion of people in contact with mental health services (end of quarter snapshot)
- Persons detained under MHA: rate per 100,000 population (end of quarter snapshot)
January 2019

Updates 17 indicators updated

Quality and Outcomes
- CPA adults in employment: % of people on CPA (aged 18-69) (end of quarter snapshot)
- Stable and appropriate accommodation: % of people on CPA (aged 18-69) (end of quarter snapshot)
- CPA review: % of people on CPA for more than 12 months who have had a review (end of quarter snapshot)
- CPA users with HoNOS assessment: % of people on CPA with HoNOS recorded (end of quarter snapshot)
- Recording of employment status: % of people in contact with mental health and learning disability services with employment status recorded (end of quarter snapshot)
- Diagnosis coding: % of people in contact with mental health services with a diagnosis or provisional diagnosis recorded (end of quarter snapshot)
- Recording of accommodation status: Percentage of people in contact with mental health services with accommodation status recorded (end of quarter snapshot)
- Delayed discharges: days of delayed discharges in the quarter: rate per 1,000 bed days
- Service users with crisis plans: % of people in contact with mental health services (end of quarter snapshot)
Services
- People on Care Programme Approach (CPA): rate per 100,000 population aged 18+ (end of quarter snapshot)
- People subject to Mental Health Act: rate per 100,000 population aged 18+ (end of quarter snapshot)
- Contact with specialist mental health services: rate per 100,000 population aged 18+ (end of quarter snapshot)
- Mental health service users on Care Programme Approach: % of mental health service users (end of quarter snapshot)
- Service users in hospital: % of mental health service users (end of quarter snapshot)
- Mental health admissions to hospital: rate per 100,000 population
- Persons detained under MHA: proportion of people in contact with mental health services (end of quarter snapshot)
- Persons detained under MHA: rate per 100,000 population (end of quarter snapshot)
  
  December 2018
  
  27 new indicators updated using the latest MHSDS and QOF data
  
  Psychosis Pathway
  
  •Severe mental illness recorded prevalence (QOF): % of practice register (all ages)
  
  Risk and related factors
  
  •Learning disability QOF prevalence: % of people on GP practice registers
  
  Services
  
  •Contact with specialist mental health services: rate per 100,000 population aged 18+
  
  •People on Care Programme Approach (CPA): rate per 100,000 population aged 18+
  
  •Mental health admissions to hospital: rate per 100,000 population
  
  •People subject to Mental Health Act: rate per 100,000 population aged 18+
  
  •Persons detained under MHA: rate per 100,000 population
  
  •CPA users with HoNOS assessment: % of people on CPA with HoNOS recorded
  
  •Mental health service users on Care Programme Approach: % of mental health service users
  
  •Service users in hospital: % of mental health service users
  
  Quality and outcomes
  
  •CPA adults in employment: % of people on CPA (aged 18-69)
  
  •Persons detained under MHA: proportion of people in contact with mental health services Stable and appropriate accommodation: % of people on CPA (aged 18-69)
  
  •Delayed discharges: days of delayed discharges in the quarter: rate per 1,000 bed days
  
  •Recording of employment status: % of people in contact with mental health and learning disability services with employment status recorded
  
  •Diagnosis coding: % of people in contact with mental health services with a diagnosis or provisional diagnosis recorded
  
  •Recording of accommodation status: Percentage of people in contact with mental health services with accommodation status recorded
  
  •Service users with crisis plans: % of people in contact with mental health services
  
  •People with SMI who have comprehensive care plan: % of people with SMI
  
  •Patients on lithium therapy with record of serum creatinine and TSH: % with record in the preceding 9 months
  
  •Patients on lithium therapy with levels in therapeutic range: % within preceding 4 months
  
  •Exception rate for severe mental illness (SMI) QOF indicators: % of patients excluded from mental health quality indicators
  
  •Patients with SMI with alcohol consumption check: % with record in preceding 12 months
  
  •Female patients with SMI who had cervical screening test: % tested in preceding 5 years
  
  •Smokers on GP registers (certain conditions) offered cessation support and treatment: % within preceding 12 months
  
  •Staff training: % of staff receiving job-relevant training, learning or development in last 12 months
  
  •Staff health & safety training: % of staff receiving mandatory training in last 12 months
  
  •Staff witnessing potentially harmful errors, near misses or incidents: % staff witnessing in last month
  
  •Staff engagement: overall score

Severe Mental Illness

Severe Mental Illness

Introduction

Significant updates

Supporting documents

Indicator list SMI profile: tool content at a glance

Contents

Recent updates

July 2023

February 2023

December 2022

October 2022

The following indicators were also updated:

August 2022

May 2022

April 2022

The following indicators were also updated:

December 2021

The following indicators were also updated:

August 2021

April 2021

The following new indicators have been added:

The following indicators have been updated:

March 2021

December 2020

Quality and Outcomes domain

Psychosis Pathway domain

Prevalence domain

Services domain

Quality and Outcomes domain

August 2020

January 2020

September 2019

Aug 2019

July 2019

June 2019

January 2019

December 2018

Recent updates

July 2023

February 2023

December 2022

October 2022

The following indicators were also updated:

August 2022

May 2022

April 2022

The following indicators were also updated:

December 2021

The following indicators were also updated:

August 2021

April 2021

The following new indicators have been added:

The following indicators have been updated:

March 2021

December 2020

Quality and Outcomes domain

Psychosis Pathway domain

Prevalence domain

Services domain

Quality and Outcomes domain

August 2020

January 2020

September 2019

Aug 2019

July 2019

June 2019

January 2019

December 2018

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