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HRB report latest data on psychiatric admissions and discharges

There were 17,000 admissions to Irish psychiatric hospitals and units during 2018 according to the latest figures from the Health Research Board (HRB). This represents an increase of 257 from 2017. Depression, schizophrenia, mania, neurosis and alcoholic disorders account for over two-thirds of all admissions.

Infographic  of main diagnosis: 24% depressive disorder, 20% schizophrenia, 9% mania, 6% alcoholic

According to Antoinette Daly, Research Officer at the HRB;

'This is the third small increase in admissions the past ten years. However, the prevailing pattern is an overall decline in admissions from 20,195 admissions in 2009 to 17,000 in 2018. Small increases, also recorded in 2013 and 2015, have not affected this fall in admissions over time’.

‘Meanwhile, the number of admissions under 18 years-of-age decreased from 441 in 2017, to 408 in 2018, with 16% of these admissions aged 14 years or younger. More than three quarters of these young people were admitted for the first time in 2018 and 84 were admitted to adult units. Sixty-three per cent were female and depression accounted for almost one-in-three of admissions of those under 18 years’.

‘There has been a slight increase in the number of admissions for under 18s over the ten-year period from 367 in 2009 to 408 in 2018,’ explains Ms Daly. ‘The proportion of under 18 admissions to adult units has dropped from 58% in 2009 to almost 21% in 2018, while admissions to child and adolescent units increased from 42% in 2009 to 79% in 2018. This reflects a change in provision of child services and practice in relation to psychiatric admissions’.

According to Dr Darrin Morrissey, Chief Executive at the HRB;

‘Behind these figures are real people who are experiencing serious mental ill health. The benefit of HRB information systems is that they record data over time, so we can track trends and see them develop. This is useful to inform policy and plan services in line with people’s needs’.

Overview of figures from 2018

  • There were 17,000 admissions to Irish psychiatric units and hospitals in 2018. This is an increase in admissions by 257 from 16,743 admissions in 2017.
  • First admissions increased by 134, from 5,905 in 2017 to 6,039 in 2018, accounting for 35.5% of all admissions in 2018.
  • Re-admissions increased by 123, from 10,838 in 2017 to 10,961 in 2018, accounting for 64.5% of all admissions in 2018.
  • There was an equal proportion of male and female admissions.
  • The mean age at admission was 45 years, with a median age of 43 years.
  • The 20–24 year age group had the highest rate of all admissions, at 608.8 per 100,000 and first admissions, at 291.3 per 100,000.
  • The 75 year and over age group had the lowest rate of all admissions, at 373.4 per 100,000.
  • The 65–74 year age group had the lowest rate of first admissions, at 131.5 per 100,000.
  • More than half (59%) of all and first (57%) admissions were single.
  • Married persons accounted for 24% of all admissions, with widowed and divorced persons accounting for 4% each.
  • Divorced persons had the highest rate of all admissions, at 636.2 per 100,000, and of first admissions, at 183.8.
  • Married persons had the lowest rate of all (230.1) and first admissions (84.3).
  • The number of admissions with no fixed abode increased from 243 in 2017, to 306 in 2018.
  • Seventy-four per cent of admissions with no fixed abode were male; 81% were single.

Diagnosis

Depressive disorders, schizophrenia, mania and neuroses combined accounted for almost two-thirds
of all admissions.

  • Depressive disorders were the most common diagnoses recorded for all and first admissions, accounting for 24% of all and 26% of first admissions.
  • Schizophrenia accounted for 20% of all and 14% of first admissions.
  • Mania accounted for 9% of all and 6% of first admissions.
  • Neuroses accounted for 9% of all and 12% of first admissions.
  • Alcoholic disorders accounted for 6% of all and 6% of first admissions.

Admissions for under 18s

  • There were 408 admissions for under 18s in 2018, a decrease from 441 in 2017.
  • Almost 78% of admissions for under 18s were first admissions.
  • Females accounted for 63% of under 18s admissions and males 37%.
  • There were 84 admissions for under 18s to adult units in 2018 and 324 admissions to child and adolescent in-patient units.*
  • Thirty-one per cent of all admissions for under 18s had a diagnosis of depressive disorders, 15% had a diagnosis of neuroses, 12% had schizophrenia and 8% had eating disorders, with the remaining proportions distributed amongst the other diagnostic groups.
  • Females outnumbered males in all of the main diagnostic groups with the exception of other drug disorders for which males accounted for 57% of all admissions.
  • Females accounted for 59% of all admissions for under 18s with a diagnosis of depressive disorders (down from 67% in 2017), 59% of admissions with neuroses (up from 44% in 2017), 54% of admissions with schizophrenia (up from 38% in 2017) and 85% of admissions with eating disorders (down from 89% in 2017).
  • Eighty-five per cent of all admissions for under 18s in 2018 were discharged during 2018.
  • The average length of stay for all under 18s in 2018 was 43.3 days (median 33 days).
  • Average length of stay was longest in child and adolescent units, at 52.7 days (median 41 days), followed by general hospital psychiatric units, at 12.6 days (median 5 days) and psychiatric hospitals/continuing care units, at 7 days (median 6 days).

Involuntary admissions

  • The proportion of involuntary admissions remained virtually unchanged from 2017, at 13% of all and 14% of first admissions.
  • Involuntary admissions accounted for 18% of all admissions to psychiatric hospitals/continuing care units, 16% of all admissions to general hospital psychiatric units and just 3% of all admissions to independent/private and private charitable centres were involuntary.

Discharges and deaths

  • There were 16,800 discharges and 137 deaths in 2018.
  • Deaths increased by 18, from 119 in 2017.
  • Males accounted for almost two-thirds (66%) of all deaths and 82% of deaths were aged 65 years and over.
  • Ninety-two per cent of all admissions in 2018 were discharged in 2018.
  • The average length of stay for all discharges in 2018 was 62.9 days (median 15 days).

Hospital type

  • The proportion of admissions by hospital type remained relatively unchanged from 2017.
  • Sixty per cent of all admissions in 2018 were to general hospital psychiatric units, 25% were to independent/private or private charitable centres and 15% were to psychiatric hospitals/continuing care units.
  • Admissions to independent/private and private charitable centres had an older mean age at admission, at 51.7 years (median 53), than that in general hospital psychiatric units, at 42.0 years (median 40) and psychiatric hospitals/continuing care units, at 45.8 years (median 44).

In-patient bed days

  • The total number of in-patient days used in 2018 was 895,206.**
  • Schizophrenia accounted for over one-third of all in-patient days in 2018, at 300,498 days.
  • Depressive disorders accounted for 16%, at 145,026 days.
  • Organic mental disorders accounted for 11%, at 102,230 days.
  • Admissions to general hospital psychiatric units accounted for one-third of these in-patient days, at 295,564, psychiatric hospitals/continuing care units accounted for 39%, at 348,682 and independent/private and private charitable centres accounted for 28%, at 250,960.

*Including private child and adolescent units

** This included the number of in-patient days used by all admissions in 2018, all discharges in 2018 with an admission date prior to 2018 and all patients resident on 31 December 2018 with an admission date prior to 2018. This yielded the total number of in-patient days used in all approved centres (adult units) in 2018, from January 1 to date of discharge or to the night of December 31 where a patient was not discharged before year-end.

ENDS

For more information, queries or infographics, please contact:

Gillian Markey, Communication Manager, Health Research Board
m 087 2288514 e gmarkey@hrb.ie

Notes to editors

The report is compiled from data supplied by 67 approved psychiatric units and hospitals on the Register of Approved Centres.