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Trends in discharges for those with a psychiatric illness from acute general hospitals and psychiatric units and hospitals in Ireland.

Whereas there is general acceptance that serious psychiatric illness is best treated in specialised psychiatric inpatient settings there is little debate on the role of the non-psychiatric acute hospital in caring for less severe psychiatric disorder.

Because, despite recent progress, Ireland lags behind both the UK and US in the provision of general hospital psychiatric units it is plausible that patients with psychiatric disorders continue to be admitted to acute general hospital non-psychiatric settings because of stigma avoidance or for other reasons such as the unavailability of a general hospital psychiatric unit locally. 
                                                                                                      
While data exists separately on admissions and discharges to inpatient facilities from NPIRS and on discharges from general medical hospitals from HIPE, no study known to the authors has examined combined data from both sources to examine the extent of the treatment of psychiatric illness in hospitals and units in Ireland. In addition, little data exists on the trends in inpatient psychiatric care for children and adolescents in Ireland. The lack of specialised child and adolescent services to date has meant that children have been and continue to be routinely admitted to adult inpatient units, which are deemed inappropriate for their needs. A study by McGilloway et al. (2000) reported that 43% of all teenage admissions in Northern Ireland were to adult inpatient psychiatric facilities. In Ireland in 2006, it was reported that 39% of child and adolescent admissions were to general hospital psychiatric units; 17% were to psychiatric hospitals, 7% were to private hospitals and 36% were to child and adolescent units (Daly et al., 2007).

The aim of this study is to determine the extent to which patients with psychiatric illness as their principal diagnosis are treated in Irish acute general hospitals and to compare their clinical characteristics with those cared for in psychiatric settings. It will also examine discharges for under 18s in both general hospitals and in psychiatric facilities. Data on discharges from NPIRS and HIPE from 1997-2006 will be extracted from both databases and analysed.

The expected date of completion of the study is December 2009.   For more information please contact Antoinette Daly adaly(at)hrb.ie or telephone 01 2345142