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HRB publish inpatient psychiatric unit and hospital census data

20 December 2016

The report presents the census data from psychiatric units and hospitals on 31 March 2016 including details such as demographics, diagnosis, length-of-stay. It also looks at some of the key trends in these areas over the past 50 years.

According to Dr Graham Love, Chief Executive at the Health Research Board,

“These data are crucial to increase our understanding of service demand in this area and to inform decisions about service planning”.

Key findings 2016

There were 2,480 patients resident in Irish psychiatric units and hospitals on 31 March 2016, seven more patients than were resident in 2013 and representing a hospitalisation rate of 52.5 per 100,000 population.

  • Males accounted for over half of all patients on census night.
  • Over one-third (36%) of in-patients were aged 65 years and over on census night. 
  • Three patients were under 18 years of age in adult units on census night. There were an additional 81 patients resident in child and adolescent units, bringing the total number of under 18s on census night to 84. 
  • Almost two-thirds (65%) of under 18s resident on census night were female. Twenty-seven per cent of under 18s were aged 17 years on census night, 25% were aged 16 years, 26% were aged 15 years, 21% were aged 13-14 years. 
  • Almost one-third (32%) of all patients on census night had a primary admission diagnosis of schizophrenia, almost 17% had a diagnosis of depressive disorders, almost 12% had organic mental disorders, 8% had mania and  5% had an intellectual disability.
  • Twenty-six per cent of under 18s had a primary admission diagnosis of depressive disorders, 17% had a diagnosis of eating disorders, 14% had a diagnosis of schizophrenia and 11% had a diagnosis of neuroses.
  • Seventeen per cent (16.7%) of in-patients on census night were involuntary, an increase in the proportion of involuntary in-patients in the last two successive censuses, from 13% in 2010 and 15% in 2013.
  • Thirty-six per cent of in-patients on census night were long-stay, i.e. had been in hospital continuously for one year or more; 17% were new long-stay, i.e. had been in hospital continuously for between one and five years; 19% were old long-stay, i.e. had been in hospital for five years or more.
  • Over half (55%) of all long-stay patients, i.e. those who had been hospitalised for one year or more, were aged 65 years or more on census night.
  • The total number of in-patient days accumulated by all patients on census night was 3,636,469 which equates to 9,963 years of in-patient care, an average of 4 years per patient.  Patients with a diagnosis of schizophrenia and intellectual disability together accounted for almost three-quarters of all in-patient days on census night; schizophrenia accounted for 43% and intellectual disability accounted for 31%.
  • Patients with intellectual disability had the longest average length of stay, at 9,270.52 days (median 7,829.0 days).
  • One-third of all in-patients were resident in general hospital psychiatric units, 32% were resident in psychiatric hospitals/continuing care units, 26% were resident in independent/private and private charitable centres, 4% were resident in the Central Mental Hospital, 4% were resident in St Joseph’s Intellectual Disability Service and less than one per cent (0.8%) were resident in Carraig Mór, Cork.

Key trends over time

  • Our census data over the last 50 years has shown a decline in in-patient numbers of 88% since 1963 and a 14% decline since 2010. A huge factor in this decline has been the decline in the old long-stay population, i.e. those in hospital for five years or more, which declined from 61% in 1963 to 19% in 2016. Lengths of stay in hospital have typically become shorter, with an increase in stays of up to three months from 14% in 1971 to 49% in 2016.  
  • The proportion of in-patients with a primary diagnosis of schizophrenia declined from 53% in 1963 to 32% in 2016 reflecting, in part, the availability of community-based treatment alternatives.  The proportion of in-patients with a primary diagnosis of intellectual disability has more than halved, from 14% in 1963 to 5% in 2016 again due to more appropriate placement of people with intellectual disability in community settings.
  • The proportion of involuntary hospitalisation has declined from 79% in 1971 to 17% in 2016 and although this is an overall downward trend, an increase in the last three census years has been noted, 13% in 2010 to 15% (14.7) in 2013 and 17% (16.7) in 2016.
  • The proportion of patients resident in psychiatric hospitals/continuing care units continues to fall, from 90% in 1981 to 32% in 2016, while the proportion resident in general hospital psychiatric units continues to rise, from 3% in 1981 to 33% in 2016.  This trend is consistent with the findings from the recent published Activities report.  Similarly, the proportion resident in independent/private and private charitable centres continues to rise, from 10% in 1981 to 26% in 2016 (up from 24% in 2013).
  • The increased numbers of under 18s resident, from 43 in 2010, to 64 in 2013 and 84 in 2016, is largely a reflection of increased capacity in child and adolescent in-patient services in line with policy.

A copy of the publication and related tables are available at the link below.

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