Home > Activities of Irish psychiatric units and hospitals 2017. Main findings.

Daly, Antoinette and Craig, Sarah (2018) Activities of Irish psychiatric units and hospitals 2017. Main findings. Dublin: Health Research Board.

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There were 16,743 admissions to Irish psychiatric hospitals and units during 2017 according to the latest figures from the Health Research Board (HRB); a decrease of 547 from 2016.  Depression, schizophrenia, mania and neurosis account for almost two-thirds of all admissions.

 

'The younger age groups had the highest rates of admission in 2017, similar to 2016', says Antoinette Daly, Research Officer at the HRB. The 20-24 age group had the highest rate of all admissions while 18-19 year olds had the highest rate of first admissions. Depression accounted for almost one-in-three of admissions for under young people under 18 years'.

'The number of admissions for young people under 18 years has increased slightly over the last 10 years.  This mirrors an increase in capacity in the child and adolescent inpatient services. in 2008 there were only two HSE child and adolescent (C&A) units and one independent/private unit  but this increased to four HSE units plus two independent/private C&A units in 2017'.

 

Depression continues to be the most common diagnosis on admission for all admissions. As in previous years, females accounted for a higher proportion of all admissions for depressive disorders at 55% compared with 45% for males.

 

Other diagnoses also show male/female differentials:

 

  • Alcohol disorders, 59% male, 41% female;
  • Other drug disorders 77% male, 23% female;
  • Schizophrenia 60% male, 40% female;
  • Mania 57% female, 43% male;
  • Eating disorders 93% female, 7% male.

 

'This report provides high-quality, timely and relevant data to help inform policy and service planning in the area of mental health', adds Dr Mairead O'Driscoll, Interim Chief Executive at the Health Research Board.

 

The report is compiled from data supplied by 65 approved psychiatric units and hospitals on the Register of Approved Centres.

 

Overview of figures from 2017

  • There were 16,743 admissions to Irish psychiatric units and hospitals in 2017, a rate of 351.6 per 100,000 total population.  This is a decrease in the number of admissions by 547, from 17,290 in 2016 and a decrease in the rate of admissions from 376.8 in 2016 to 351.6 per 100,000 in 2017.
  • First admissions decreased by 192, from 6,097 in 2016 to 5,905 in 2017. The rate of first admissions also decreased from 132.9 in 2016 to 124.0 in 2017.
  • Re-admissions decreased by 355, from 11,193 in 2016 to 10,838 in 2017. The rate of re-admissions decreased from 243.9 in 2016 to 227.6 in 2017.
  • There was an equal proportion of male and female admissions.
  • The 20–24 years age group had the highest rate of admission, at 574.5 per 100,000 of the population.  This was followed by the 55-64 years age group at 472.1.
  • The lowest rate of admissions was among the 75 years and over age group at 406.0 per 100,000.
  • The 18–19 years age group had the highest rate of first admissions, at 302.9 per 100,000.
  • Almost 6 in 10 of all admissions were single people.
  • Married persons accounted for 25% of all admissions, widowed and divorced people accounted for 4% each.
  • While divorced people accounted for only 4% of all admissions, they had the highest rate of all admissions at 580.4 per 100,000.
  • Forty per cent of all admissions in 2017 were unemployed.
  • Homeless people accounted for 243 admissions in 2017. Seventy-two per cent were male and 72% were single.

 

In terms of diagnosis

Depression, schizophrenia, mania and neuroses were the main diagnoses for admission, together accounting for almost two-thirds of all admissions.

The most common diagnosis recorded for all admissions was depressive disorders, accounting for 25% of all, 26% of first admissions and the highest rate of all (87.0) and first (32.7) admissions.

  • Schizophrenia accounted for 20% of all, 13% of first and had the second-highest rate of all admissions (71.7 per 100,000).
  • Mania accounted for 11% of all admissions.
  • Neuroses accounted for 9% of all admissions.

 

Involuntary admissions

  • Involuntary admissions accounted for 13% of all and 13% of first admissions, virtually unchanged from 2016.
  • There was a reduction in the rate of involuntary admissions from 48.4 in 2016 to 45.4 per 100,000 in 2017.
  • 18% of all admissions to psychiatric hospitals/continual care units and 16% of admissions to general hospital psychiatric units were involuntary, compared with 2% of admissions to independent/private and private charitable centres. These proportions are unchanged from 2016.

 

Discharges and deaths

  • There were 16,554 discharges from and 119 deaths in Irish psychiatric units and hospitals.
  • Males accounted for 57% of all deaths and 82% of those who died were aged 65 years and over.
  • Ninety-two per cent of all and 93% of first admissions in 2017 were discharged within the year.
  • The average length of stay for all discharges was 52.3 days (median 15 days).
  • Over half (54%) of all discharges from general hospital psychiatric units and 49% of discharges from psychiatric hospitals/continuing care units were discharged within two weeks of admission, compared with 25% of discharges from independent/private and private charitable centres.

 

Community Healthcare Organisations (CHOs)

  • Admission rates were highest for CHO* 9 at 388.0 per 100,000, and lowest in CHO 6 at 323.3 per 100,000 of the population.

 

Hospital type

  • Sixty per cent of all admissions in 2017 were to general hospital psychiatric units, 25% were to independent/private and private charitable centres, and 16% were to psychiatric hospitals/continuing care units.
  • Admissions to independent/private and private charitable centres had an older age profile (average 52 years) than either general hospital psychiatric units (42 years) or psychiatric hospitals/continuing care units (47 years).

 

Young people under 18 years of age (including admissions to child and adolescent services) 

  • There were 441 admissions to all hospital types for under 18s in 2017, a decrease from 506 admissions in 2016.
  • Eighty per cent of all admissions for under 18s were first admissions.
  • There were 355 admissions to child and adolescent  in-patient units.
  • There were 86 admissions for under 18s to adult units and hospitals.
  • Females accounted for 60% of all and first admissions.
  • Depressive disorders accounted for 30% of all and 32% of first admissions for under 18s, 14% had a diagnosis of eating disorders, 12% had a diagnosis of schizophrenia and 11% had a diagnosis of neurosis.
  • Females accounted for 67% of all admissions with depressive disorders, 89% of admissions with eating disorders, and 52% of admissions with mania.
  • Males accounted for 62% with a primary admission diagnosis of schizophrenia and 87% of admissions with other drug disorders.
  • Eighty-one per cent of under 18s admitted in 2017 were discharged in 2017. The average length of stay for those admitted and discharged in 2017 was 45.7 days (median 39 days).
  • Of those admitted and discharged in 2017, 18% were discharged within one week of admission, 8% were discharged within one to two weeks, 14% were discharged within two to four weeks, 47% were discharged within one to three months and 12% were discharged within three months to one year.

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