News roundup

Published:

HRB reports 2020 trends in psychiatric inpatient treatment

The latest figures from the Health Research Board (HRB) reveal an overall decrease in admissions to psychiatric units and hospitals in 2020 as a result of strict public health measures related to the COVID-19 pandemic.

Front cover of the Annual Report on the Activities of Irish Psychiatric Units and Hospitals 2020

Commenting on the latest figures, Dr Sarah Craig, Head of National Health Information Systems at the HRB says:

"There has been a great deal of public discourse on the effects of societal restrictions on mental health and wellbeing. The figures indicate increasing and/or decreasing demand for treatment among different groups. In reviewing this year’s figures it’s important to note that while fluctuations in the number of admissions may reflect real changes in demand for psychiatric treatment, they also reflect the compliance with COVID-19 restrictions, which required a reduction in the number of inpatient beds and a need to facilitate social distancing."

Overview of 2020 figures

There was a decrease of 8% in admissions to Irish psychiatric units and hospitals from 16,710 in 2019 to 15,391 in 2020.

  • There was an increase of over 400 in first-time admissions, from 5,277 in 2019 to 5,694 in 2020.
  • There was an increase in the number of involuntary admissions, from 14% of admissions in 2019 to 16% in 2020.
  • There was an equal proportion of male and female admissions.
  • The median age of all admissions was 43. However, the 20-24 age group had the highest overall rate of admissions (545 admissions per 100,000).
  • Consistent with previous years, admissions were more likely to be single, unemployed, and diagnosed with a depressive disorder.
  • Depressive disorders again had the highest rate of all admissions, followed by schizophrenia, mania, and neuroses. Combined, these disorders accounted for over two-thirds of all admissions.
  • The number of admissions reporting no fixed abode increased, from 297 in 2019 to 312 in 2020.
  • Admissions reporting no fixed abode were more likely to be single males with a diagnosis of schizophrenia or other drug disorders*.

Admissions for under 18s

  • There were 486 under 18s admitted to psychiatric units and hospitals in 2020. Twenty-seven children were admitted to adult psychiatric units and hospitals, a 50% decrease from 2019. The remaining 459 were admitted to child and adolescent units**.
  • Consistent with previous years, depressive disorders were the most common reason for admission (31%), followed by eating disorders (18%), neuroses (10%) and schizophrenia (8%).
  • Seven-in-ten admissions under 18 years old were female.
  • Females accounted for nine-in-ten admissions with an eating disorder, seven-in-ten admissions with a depressive disorder and almost seven-in-ten admissions with neuroses.
  • Males accounted for almost six-in-ten*** admissions with other drug disorders.

According to Dr Sarah Craig:

"A key benefit of the HRB psychiatric inpatient reporting system is that we can identify trends within psychiatric admissions over time that can help ensure services match people’s needs. For instance, the number of admissions with depressive disorders among under 18s was similar to 2019 while the number of admissions with neuroses and schizophrenia both decreased. The number of under 18s admitted with an eating disorder increased for the third year. However, several repeat admissions for eating disorders among the age group during 2020 account for much of this increase."

Dr Craig continues:

"While we note that the 2020 fluctuations in admissions predominantly reflect the societal restrictions in place throughout the year, the HRB will continue to identify and monitor these trends as we emerge from the COVID-19 pandemic to determine where needs are emerging to inform service planning."

Antoinette Daly, Research Officer at the HRB notes:

"A positive observation from our 2020 data is that the number of under 18s admissions to adult psychiatric units and hospitals continues to decrease in line with policy."

Discharges and deaths

  • There were 15,593 discharges from and 127 deaths in Irish psychiatric units and hospitals in 2020.
  • Males accounted for two-in-three deaths.
  • Eight-in-ten deaths were aged 65 years and over.
  • Ninety-three per cent of all 2020 admissions were discharged in 2020.
  • There was a decrease in the average length of stay for all discharges, from 64.2 days (median 15 days) in 2019 to 54.7 days (median 14 days) in 2020.

* Other drug disorders include Mental and Behavioural disorders due to psychoactive substance use (excluding Mental and Behavioural disorders due to use of alcohol).

** Including admissions to independent/private child and adolescent units.

*** The reduction in the proportion of other drug disorders among males from 2019 (where nine-in-ten admissions for other drug disorders were male) reflects the overall decrease in admissions for this disorder from 15 in 2019 to 7 in 2020.

The Annual Report on the Activities of Irish Psychiatric Units and Hospitals 2020 is available on the HRB website here. An infographic that outlines key data is also available for download.

ENDS

For further information, infographics or to organise interviews with experts, please contact:

Gillian Markey, Communications Manager, Health Research Board

m 087 2288514, e gmarkey@hrb.ie