Psychiatric Bed Study in England

Link Established Between More Patients Being Detained In Hospitals Involuntarily And Fewer Mental Illness Beds

Medical News Today

According to a recent study published on bmj.com, in the last 21 years hospitals across England have seen a tremendous increase in the number of patients being detained for mental illness while concurrently there has been a reduction in the number of beds for patients with this disorder. The study was conducted by experienced researchers from the Warwick University, University of London & Queen Mary, and the Newcastle University.

The research has revealed that the reduction in the number of beds for mental illness, which was actually done as part of a policy to maximize the community alternatives for hospital stay, had a direct correlation with the increasing number of involuntary patient admittance to psychiatric centres.

In recent years, with an objective to deinstitutionalise the care of the mentally ill in developed nations, the number of beds for mental illness have been cut back. To achieve this objective, several changes have also been made to the legislation in the UK such as the introduction of the Mental Health Act 1983. Despite efforts such as crisis resolution home treatment, assertive outreach and availability of community mental health teams, a number of countries have seen an increase in the involuntary patient admittance to psychiatric centres.

The increasing use of compulsory detention is quite displeasing among both, the patients and the healthcare providers. Huge expenses involved with in-patient care also make it a source of concern to service providers and commissioners.

The analysis was performed by scientists based on the data available publically in the NHS Information Centre and the Department of Health. The researchers took a note of the hospital activity statistics on the NHS mental illness bed provision and involuntary patient admittance rates, between 1988 and 2008.

It was found that for these two decades, the involuntary patient admittance rates increased from 40.2 % to 65.6 % per 100,000 adults/ year, while at the same time there was a decrease of 62 % in the number of beds for mental illness per 100,000 adults.

When a time delay of one year was applied, a substantial association between these variables was found, with bed reductions preceding the number of involuntary patient admittance. Ultimately, in the following year, the results showed that there was one extra involuntary patient admission for every two beds closed.

The information about the clinical reasons for admissions were not mentioned in the dataset that was analysed; however the authors of the study have stated that it is unlikely that the increase reflects "an otherwise unreported dramatic increase in the prevalence of severe mental disorders in England."  

The researchers conclude,

We emphasise that this paper does not suggest that bed closures are intrinsically inappropriate. This strategy may well be a reasonable course of action; but the bed mix needs to be examined more closely and the rate and consequences of bed closures may need to be considered more carefully. Overall, this study provides important evidence for the need to anticipate the effects of bed closures.

More students are hospitalized for mental health problems

July 2011, Vol 42, No. 7

Print version: page 12

An increased awareness of mental health issues is leading to more college students being hospitalized for psychological reasons, according to new data from the Association for University and College Counseling Center Directors (AUCCCD).

More than 3,700 students were hospitalized for suicide threats and other mental health issues in 2010, a significant jump from the 2,069 hospitalizations reported in 2006, the first year the survey was conducted. The survey found a rate of 7.93 hospitalizations per 10,000 students last year, up from 5.39 hospitalizations per 10,000 students in 2008, a 47 percent increase.

Anxiety was the most commonly cited complaint bringing students in to counseling centers last year, edging out depression as the top reason for seeing a counselor.

One factor driving the increase is that more universities are establishing “students of concern committees,” which coordinate the treatment of students with mental health and behavioral issues who have come to the attention of professors, campus police and residence hall advisers, says Victor M. Barr, PhD, director of the University of Tennessee at Knoxville counseling center.

Compared with years past, most institutions now have specific written policies to help students get treatment and to monitor their progress, Barr says.

The survey also found that:

• 75 percent of directors reported needing additional psychiatric services for students.
• 25 percent of students seen in counseling centers were already taking psychotropic medications.

As a result of increased demand for services, campus counseling centers are getting budget approval from their institutions to hire more psychiatrists and bring on more case managers to track treatment referrals, says Dan Jones, PhD, AUCCCD president and counseling center director at Appalachian State University.

“It used to be that counseling centers would give clients a list of three therapists and leave it in the client’s hands to get treatment when referred out,” Jones says.