New figures show that the number of psychiatric patients “sectioned” and admitted to inpatient NHS care has increased dramatically.
A study published on the website of the British Medical Journal suggests that “perhaps a new era of reinstitutionalisation has begun”.
Dr Patrick Keown, a consultant psychiatrist in Newcastle, UK, and colleagues investigated psychiatric care in England between 1996 and 2006. They found that involuntary detentions (under the Mental Health Act 1983) increased by 20 per cent, but the number of NHS psychiatric beds fell by 29 per cent. There was also a significant rise in the number of patients admitted due to alcohol and drug problems.
“Patients admitted involuntarily occupied 23 per cent of NHS psychiatric beds in 1996 but 36 per cent in 2006,” the authors report.
They conclude: “Psychiatric inpatient care changed considerably in the decade from 1996 to 2006, with more involuntary admissions to fewer NHS beds. The case mix has shifted further towards psychotic and substance misuse disorders, which has changed the milieu of inpatient wards.”
In an editorial, Professor Scott Weich of Warwick University, UK, writes that NHS inpatient psychiatric care is expensive, unpopular, and often unsatisfactory.
Although “there will always be a need for sanctuary at times of crisis”, Professor Weich believes that the quality of service provision focus needs more attention, because “the answer lies outside inpatient units rather than within them”.
The Royal College of Psychiatrists’ Fair Deal campaign highlights these problems and suggests solutions, he writes. But it will only succeed if users’ and carers’ voices are heard and acted on, he concludes.
Keown, P. et al. A retrospective analysis of hospital episode statistics, involuntary admissions under the Mental Health Act 1983, and the number of psychiatric beds in England 1996-2006. The British Medical Journal, 2008;337:a1837.
Weich, S. Availability of inpatient beds for psychiatric admissions in the NHS. The British Medical Journal, 2008;337:a1561.
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