Unemployed and unskilled workers most likely to be admitted to psychiatric care

Study shows 20–24 year age group had highest rate of admissions

The Central Mental Hospital, Dublin. Photograph: Alan Betson

The Central Mental Hospital, Dublin. Photograph: Alan Betson

 

Residents of north and west Dublin and unemployed and unskilled workers were most likely to be admitted to psychiatric care last year, a report published on Thursday shows.

The study, from the Health Research Board (HRB), also indicates patients of public psychiatric units were far more likely to be discharged within a week than those admitted to private units, where patients often stayed several months.

While admissions to psychiatric hospitals have fallen from a peak in the mid-1980s, admissions to child and adolescent units increased by 63 per cent in the last decade – from 272 in 2010 to 443 last year.

This may reflect an increased bed capacity in child and adolescent mental health services in the last decade.

Drawing on data returned to the National Psychiatric In-patient Reporting System, on admissions to and discharges from the 66 psychiatric units, the HRB reports that males accounted for 51 per cent of the 16,710 admissions last year.

Adolescent units

Among children in contrast, girls accounted for almost 70 per cent of 443 admissions (67 per cent)to child and adolescent units.

Overall, the 20 to 24-year age group had the highest rate of admissions, at 568.3 per 100,000, followed by the 18 to 19-year age group, at 484.6 and the 55 to 64-year age group, at 471.4.

The 75 year and over age group had the lowest rate of all admissions, at 373.8.

Depression and depressive disorders were the most common reason for admission, accounting for almost a quarter. Schizophrenia accounted for 21 per cent with mania and neuroses each accounting for 10 per cent.

Where an occupation was indicated 40 per cent were unemployed; 24 per cent were employed; 9 per cent were retired; 6 per cent were students; 4 per cent were engaged in house duties and 17 per cent were unknown.

“As in previous years, the unskilled occupational group had the highest rate of all (482.5 per 100,000) . . . agricultural workers had the second-highest rate of all admissions (375.9 per 100,000), followed by manual skilled workers (248.3 per 100,000) and semi-skilled workers (238.4 per 100,00).”

North and west Dublin had the highest admission rate – at 402.5 people per 100,000, compared with counties Galway, Roscommon and Mayo which had the lowest at 310.1.

North and west Dublin also had highest rates of involuntary admissions at 72.4 per 100,000, compared with 18.4 in Cork and Kerry with the lowest.

Divorced people had the highest rate of all admissions, at 442.8 per 100,000, followed by single people at 385.4 and widowed people at 357.7. Married people had the lowest rate at 223.3 per 100,000.

Diagnosis

There were 297 admissions of homeless people down from 306 in 2018. Of these, 71 per cent were male and 76 per cent were single. The largest proportion (28 per cent) had a diagnosis of schizophrenia.

The length of time patients stay in public psychiatric units appears to be far shorter than for those in private or independent units. Over 40 per cent of psychiatric patients in the Mater hospital were discharged within a week (44 per cent), with a similar timeframe for discharges from the Drogheda department of psychiatry (45 per cent), and, Letterkenny general hospital (41 per cent).

In contrast, less than 20 per cent of discharges from St Patrick’s Hospital, Dublin were within a week (18 per cent), just 15 per cent from St Edmundsbury, Lucan, Dublin, and 11 per cent from St John of God Hospital, Dublin.

Bloomfield Hospital in Rathfarnham, Dublin, had the longest average length of stay among the independent/private and private charitable centres, at 1,018.1 days (median 609 nights), followed by Cois Dalua, a mental health rehabilitation centre in Cork, at 399 nights.