Women, older people and people who are single have a longer length of stay in psychiatric hospitals and units than men or those who have a relationship and support system, new research has found.
On Monday, the Economic and Social Research Institute (ESRI) published a paper on factors that determine how long an individual stays for mental health treatment, and found a “significant” geographic variation.
The study looked at the number of discharges from acute adult psychiatric units between 2015 and 2019, due to this being the most recent data available that was unaffected by Covid-19.
The researchers excluded patients under 18, patients who died during their stay, non-residents of Ireland and those who required a stay of over 180 days, providing a total of 60,607 discharges during this period.
High levels of air pollutants that can cause respiratory, heart and brain issues found in Dublin hotspots
Leo Varadkar is right: basic maths should not flummox a minister or any of us
Dublin hotel bar manager accused of ‘defrauding customers’ by adding 10% service charge to bills
Soc Dems suspend Eoin Hayes for giving incorrect information about sale of shares from firm linked to Israeli military
Between 2015 and 2019, there were approximately 12,000 discharges annually from acute adult psychiatric inpatient hospitals or units, accounting for approximately 250,000 bed days.
A majority of the patients were aged under 45 years (58.4 per cent), single (64.3 per cent), white (88.4 per cent), unemployed (51.5 per cent), born in Ireland (82.5 per cent), voluntary admissions (84.7 per cent), and readmissions (63.9 per cent).
The average length of stay was 20.9 days, but this varied “considerably” by patient and clinical characteristics. The average length of time for treatment for readmissions was 22.9 days, while for first-time admissions this was 17.3 days and involuntary admissions this was 32.8 days.
Patients with a diagnosis of severe mental illness (SMI) account for 37 per cent of discharges and 50 per cent of bed days.
Clinical diagnosis significantly affects length of stay, with diagnoses such as schizophrenia being associated with significantly longer stays than, for example, depressive episodes.
Older ages also have an impact, with those aged 55 to 64 years staying approximately 6.5 days longer than those aged 35 to 44 years.
Length of stay is up to two days longer for females than males, while being married, widowed, or divorced is associated with a “significantly” lower length of stay than being single.
The patient’s region of residence also had an impact on length of stay. The mean duration was generally higher in the west and southwest of the country, with the exception being CHO 6, which covered Wicklow, Dún Laoghaire and Dublin South East, which has the highest average length of stay at 24.1 days.
This area also had an average of 51 per cent of the recommended staff over this period.
According to the study, between 2006 and 2019, there has been a 20 per cent decrease in total psychiatric inpatient admissions, and a 30 per cent decrease in re-admissions.
Despite this, the current inpatient system is “under pressure” with high occupancy rates common, and one quarter of units having an occupancy rate of over 100 per cent, the researchers said.
The researchers highlighted “substantive limitations” in the data collected and reported, which they said “curtails future planning of mental health services in terms of community provision and inpatient capacity”.
“Health service providers need a comprehensive picture of the requirements of the patients in their area to appropriately tailor resources across inpatient and community services. Detailed regional level data would allow for the organisation of services so that patients have access to the most clinically beneficial treatments in the most appropriate settings,” they said.
“Without substantive improvement in the inpatient and community data collected and reported in Ireland, future planning of mental health services faces substantive challenges.”
- Sign up for push alerts and have the best news, analysis and comment delivered directly to your phone
- Join The Irish Times on WhatsApp and stay up to date
- Listen to our Inside Politics podcast for the best political chat and analysis
