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.
