The latest annual report on activities in psychiatric inpatient units and hospitals in 2004 shows that the total number of admissions to inpatient care continues to fall.1 There is an increase in admissions to general hospital psychiatric units and a decline in use of psychiatric hospitals. The report, Activities of Irish Psychiatric Services 2004, was published in December 2005 by the Health Research Board (HRB) and is the latest in a series that began forty years ago.

Figure 1 presents the rate of first admissions to inpatient psychiatric services with a diagnosis of alcohol disorder, per 100,000 of the population in Ireland between 1990 and 2004.1,2,3 It is notable that the rate of alcohol-related admissions decreased steadily between 1991 and 2004 and more than halved during the reporting period. This reflects changes in alcohol treatment policy and practices during the period and the resultant increase in community-based and special residential alcohol treatment services.

Figure 2 presents the rate of first admissions to inpatient psychiatric services with a diagnosis of drug disorder, per 100,000 of the population in Ireland between 1990 and 2004.1,2,3 It is notable that the rate increased steadily between 1990 and 1995, with a dip in 1996, and further annual increases between 1997 and 2001. The rate of drug-related admissions was almost three times higher in 2001 than it was in 1990.  The dips in 1996 and 2002 can be partly explained by the fact that the rates are calculated from new larger census numerators in 1996 and 2002 compared to the year preceding each of these years and the small number of drug dependence cases each year would be sensitive to this change in numerator.  The increasing rate of new cases of drug-related admissions between 1990 and 2001 reflects the increase in problem drug use in Ireland and its burden on the psychiatric services.  There was a notable decrease in 2002, which was sustained in 2003.  This overall decrease since 2001 possibly reflects an increase in community-based specialised addiction services during this period.

1. Daly A, Walsh D, Moran R and Kartalova O'Doherty Y (2004) Activities of the Irish Psychiatric Services 2003. Dublin: Health Research Board.

2. Daly A, Walsh D, Comish J, Kartalova-O’Doherty Y, Moran R and O’Reilly A (2005) Activities of Irish psychiatric units and hospitals 2004. Dublin: Health Research Board.

3. Walsh D and Daly A (2004) Mental illness in Ireland 1750–2002: reflections on the rise and fall of institutional care. Dublin: Health Research Board.