Irish psychiatric units and hospitals census 2006 / Antoinette Daly and Dermot Walsh
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Authors Daly, Antoinette;Walsh, Dermot
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Link to Item http://hdl.handle.net/10147/44707
Find this and similar works at - http://www.lenus.ie/hse Irish Psychiatric Units and Hospitals Census 2006 Irish PsychiatricIrish Units and Hospitals Census 2006 www.hrb.ie
Antoinette Daly and Dermot Walsh Irish Psychiatric Units and Hospitals Census 2006
Antoinette Daly and Dermot Walsh with assistance from Yvonne Dunne, Deirdre Hallissey and Fiona Bannon
Mental Health Research Division Health Research Board, Dublin December 2006 Irish Psychiatric Units and Hospitals Census 2006 An BordTaighde Sláinte © HealthResearchBoard,2006 ISSN 1649-9107 w e f t Dublin 2,Ireland 73 LowerBaggotStreet An BordTaighde Sláinte Health ResearchBoard Published by Mr ConorTeljeur oftheSmallAreaResearchUnitinTrinity CollegeDublinfortheuseofmapsthroughoutreport. and externalreviewersofthereportourcolleagueswhogaveustheircommentsonit.Ourthanksarealsoextendedto and hospitalswhoco-operatedwithusbysubmittinginformationforthisreport.We wouldalsoliketothanktheinternal The MentalHealthResearchDivisionoftheBoardwouldliketothankallpersonnelinpsychiatricunits Acknowledgements
www.hrb.ie [email protected] + 35316611856 + 35316761176
Irish Psychiatric Units and Hospitals Census 2006 Irish Psychiatric Units and Hospitals Census 2006 6. 5. 4. 3. 2. 1. Summary Glossary offigures List tables of List Contents
The decline of the long-stay declineof in-patient population The Individual psychiatric unitsandhospitals type Hospital ExecutiveHealth Service administrative areas National findings Introduction andbackground information Conclusions andthefuture Long-stay in-patientsinpsychiatric hospitals Attrition amongthelong-stayin-patientpopulation The long-stayin-patientpopulation1971–2006 Length ofstay Legal status Diagnosis Socio-economic group Marital status Gender andage Length ofstay Legal status Diagnosis Socio-economic group Marital status Gender andage International comparisons Children’s centres Length ofstay Legal status Diagnosis Socio-economic group Marital status Gender andage NPIRS/COMCAR Limitations Diagnosis Data collectionprocedure Data coverage 39 47 55 19 73 15 76 75 74 73 48 48 48 47 47 47 41 40 40 40 40 40 27 26 24 24 22 21 20 19 17 16 16 16 15 11 9 8 5
Irish Psychiatric Units and Hospitals Census 2006 Irish Psychiatric Units and Hospitals Census 2006 Mental HealthResearchDivisionPublications Appendix 2 Sample datacollectionform Appendix 1 References 80 79 78
Irish Psychiatric Units and Hospitals Census 2006 Irish Psychiatric Units and Hospitals Census 2006
2. 1. text tables in of List Table 2.18 Table 2.15 Table 2.21 Table 2.17 Table 2.19 Table 2.16 Table 2.13 Table 2.20 Table 2.14 Table 2.12 Table 2.11 Table 2.10 Table 2.9 Table 2.8 Table 2.7 Table 2.6 Table 2.5 Table 2.4 Table 2.3 Table 2.2 Table 2.1 Table 1.2 Table 1.1 National findings Introduction andbackground information Irish PsychiatricUnitsandHospitalsCensus2006.Diagnosis andsocio-economicgroup. admission. Numberswithrates per100,000populationaged16yearsandover. 100,000 populationaged16yearsandover. Irish PsychiatricUnitsandHospitalsCensus2006.Socio-economicgroupgender. per 100,000populationaged16yearsandover. Irish PsychiatricUnitsandHospitals Census2006.Legalcategoryoncensusnightbyorder of Numbers andpercentageswith ratesper100,000populationaged16yearsandover. Irish PsychiatricUnitsandHospitalsCensus2006.Diagnosis andage.Numberswithratesper with ratesper100,000populationaged16yearsandover. Irish PsychiatricUnitsandHospitalsCensus2006.Legalstatus oncensusnightandgender. Numbers withratesper100,000populationaged16yearsand over. Irish PsychiatricUnitsandHospitalsCensus2006.Diagnosis andgender. Numbersandpercentages Numbers andpercentageswithratesper100,000populationaged16yearsover. Irish PsychiatricUnitsandHospitalsCensus2006.Maritalstatusgender. Numbersand with ratesper100,000populationaged16yearsandover. Irish PsychiatricUnitsandHospitals Census2006.Legalstatusoncensusnightanddiagnosis. Numbers andpercentageswithratesper100,000population aged16yearsandover. Irish PsychiatricUnitsandHospitalsCensus2006.Maritalstatusage.Numberswithrates percentages withratesper100,000populationaged16yearsandover. Irish PsychiatricUnitsandHospitalsCensus2006.Agegender. Numbersandpercentages percentages withratesper100,000totalpopulation. Psychiatric in-patientsresidentinIreland,Wales, ScotlandandEnglandbygender. Numbersand Irish PsychiatricUnitsandHospitalsCensus2006.Diagnosislengthofstay. Children’s centres. Irish PsychiatricUnitsandHospitalsCensus2006.Diagnosisgender. Children’s centres. Irish PsychiatricUnitsandHospitalsCensus2006.Agegender. Children’s centres. Irish PsychiatricUnitsandHospitalsCensus1971-2006.Lengthofstay. Numberswithpercentages. Irish PsychiatricUnitsandHospitalsCensus1963-2006.Diagnosis.Numberswithpercentages. population. Irish PsychiatricUnitsandHospitalsCensus1963-2006.Socio-economicgroup.Ratesper100,000 Irish PsychiatricUnitsandHospitalsCensus1963-2006.Maritalstatus.Percentageswithrates. Irish PsychiatricUnitsandHospitalsCensus1971-2006.Agegroups.Ratesper100,000population. Irish PsychiatricUnitsandHospitalsCensus1963-2006.Gender. Numberswithpercentages. Irish psychiatricin-patientnumbers1963-2006. ICD-10 diagnosticgroups. Hospital type.
35 32 30 34 31 33 31 29 34 29 27 27 26 26 25 23 21 21 20 20 19 16 15
Irish Psychiatric Units and Hospitals Census 2006 Irish Psychiatric Units and Hospitals Census 2006
4. 3.
Table 3.3 Table 3.2 Table 3.7 Table 3.8 Table 3.6 Table 3.5 Table 3.4 Table 4.4 Table 2.26 Table 2.25 Table 2.24 Table 4.6 Table 4.5 Table 4.3 Table 2.23 Table 4.1 Table 3.1 Table 2.22 Table 4.2 Hospital type type Hospital ExecutiveHealth Service administrative areas Irish PsychiatricUnitsandHospitalsCensus2006.HealthServiceExecutiveadministrativeareasby Numbers withratesper100,000populationaged16yearsandover. Irish PsychiatricUnitsandHospitalsCensus2006.HealthServiceExecutiveadministrativeareasbyage. by gender. Numberswithratesper100,000populationaged16yearsandover. Irish PsychiatricUnitsandHospitalsCensus2006.HealthServiceExecutiveadministrativeareasby Analysis ofin-patientdays.Numberswithpercentages. Legal statusoncensusnight.Numberswithratesper100,000populationaged16yearsandover. Irish PsychiatricUnitsandHospitalsCensus2006.HealthServiceExecutiveadministrativeareas. Irish PsychiatricUnitsandHospitalsCensus2006.HealthServiceExecutiveadministrativeareas. Irish PsychiatricUnitsandHospitalsCensus2006.HealthServiceExecutiveadministrativeareasby Irish PsychiatricUnitsandHospitalsCensus2006.HealthServiceExecutiveadministrativeareasby length ofstay. Numberswithratesper100,000populationaged16yearsandover. diagnosis. Numberswithratesper100,000populationaged16yearsandover. socio-economic group.Numberswithratesper100,000populationaged16yearsandover. marital status.Numberswithratesper100,000populationaged16yearsandover. Irish PsychiatricUnitsandHospitalsCensus2006.Hospital typeandmaritalstatus. Numbers withpercentages. Irish PsychiatricUnitsandHospitalsCensus2006.Analysisofin-patientdaysbydiagnosis Numbers withpercentages. Irish PsychiatricUnitsandHospitalsCensus2006.Lengthofstaylegalstatusoncensusnight. percentages. Irish PsychiatricUnitsandHospitalsCensus2006.Lengthofstaydiagnosis.Numberswith percentages. Irish PsychiatricUnitsandHospitals Census2006.Hospitaltypeanddiagnosis. Numbers withpercentages. Irish PsychiatricUnitsandCensus 2006.Hospitaltypeandsocio-economicgroup. Numbers withpercentages. (excluding patientsinhospitalforoneyearormore).Numberswithpercentages. Numbers withpercentages. Irish PsychiatricUnitsandHospitalsCensus2006.Hospital typeandselectedagegroups. Numbers withpercentages. Irish PsychiatricUnitsandHospitalsCensus2006.Lengthofstayage.Numberswith percentages. Irish PsychiatricUnitsandHospitalsCensus2006.Hospitaltypegender. Irish PsychiatricUnitsandHospitalsCensus2006.HealthServiceExecutiveadministrativeareas Irish PsychiatricUnitsandHospitalsCensus2006.Lengthofstaygender. Numberswith Irish PsychiatricUnitsandHospitalsCensus2006.Hospital typeandage. Numbers withpercentages.
42 42 45 45 45 44 43 43 50 38 37 36 51 50 38 52 49 35 47
Irish Psychiatric Units and Hospitals Census 2006 Irish Psychiatric Units and Hospitals Census 2006
6. 5.
Table 6.7 Table 6.6 Table 6.5 Table 6.4 Table 5.8 Table 5.5 Table 5.3 Table 5.6 Table 5.4 Table 6.2 Table 5.7 Table 6.3 Table 6.1 Table 5.9 Table 5.2 Table 5.1 Table 4.8 Table 4.7 Table 4.9 The decline of the long-stay declineof in-patient population The Individual psychiatric unitsandhospitals units 2001and2005. Discharges fromlong-staycare inpublicpsychiatrichospitalsandgeneralhospital Discharges anddeathsoflong-stayin-patientsallagesduring theperiod2001–2005. Ages ofdischargesanddeathscombinedlong-stayin-patients 2001–2005. Numbers ofdischargesanddeathscombinedlong-staypatients 2001–2005. the fiveyearsprecedingeachcensusyearandyearlyaverage. Irish PsychiatricUnitsandHospitalsCensus2006.hospitalslengthofstay. Irish PsychiatricUnitsandHospitalsCensus2006.hospitals.Diagnosis. Diagnosis. Numberswithpercentages. Length ofstay. Numberswithpercentages. Irish PsychiatricUnitsandHospitalsCensus2006.Privatehospitals.Agegroups. Numbers withpercentages. Numbers withpercentages. Irish PsychiatricUnitsandHospitalsCensus2006.Privatehospitals.Diagnosis. Irish PsychiatricUnitsandHospitalsCensus2006.Generalhospitalpsychiatricunits. Numbers withpercentages. Numbers withpercentages. Irish PsychiatricUnitsandHospitalsCensus1971–2006.Long-stayin-patientsaged65years of allin-patients.Numberswithpercentages. Irish PsychiatricUnitsandHospitalsCensus2006.Generalhospitalpsychiatricunits. Numbers withpercentages. Irish PsychiatricUnitsandHospitalsCensus1971–2006.Numbers becomingnewlong-stayin and ofallelderlyin-patients. Irish PsychiatricUnitsandHospitalsCensus1971–2006.Newoldlong-stayasaproportion Irish PsychiatricUnitsandHospitalsCensus2006.Privatehospitals.Lengthofstay. Numbers withpercentages. Irish PsychiatricUnitsandHospitalsCensus2006.hospitals.Agegroups. Numbers withpercentages. Irish PsychiatricUnitsandHospitalsCensus2006.Generalhospitalpsychiatricunits.Agegroups. Irish PsychiatricUnitsandHospitalsCensus2006.Hospitaltypelengthofstay. Numbers withpercentages. Irish PsychiatricUnitsandHospitalsCensus2006.Hospitaltypelegalstatusoncensusnight. Numbers withpercentages. Irish PsychiatricUnitsandHospitalsCensus2006.Analysisofin-patientdaysbyhospitaltype. Numbers withpercentages. and over75yearsover. Numbers withpercentagesandasaproportionofallin-patients
76 75 75 75 74 59 67 57 54 58 62 73 66 74 70 55 52 72 53
Irish Psychiatric Units and Hospitals Census 2006 Irish Psychiatric Units and Hospitals Census 2006
4. 3. 2. text offigures in List
Figure 2.4In-patientsinIreland,England,Wales andScotland.Ratesper100,000totalpopulation. Figure 2.3 Figure 2.2IrishPsychiatricUnitsandHospitalsCensus1963,1991,20012006.Legalstatus. Figure 3.2 Figure 4.1 Figure 3.1 Figure 2.1 Hospital type Hospital ExecutiveHealth Service administrative areas National findings Percentages. Percentages. Irish PsychiatricUnitsandHospitalsCensus2006.Hospitaltypebyselecteddiagnoses. Percentages. Irish PsychiatricUnitsandHospitalsCensus1971,1981,1991,20012006.Lengthofstay. population aged16yearsandover. HSE administrativeareas.Ratesper100,000populationaged16yearsandover. Irish PsychiatricUnitsandHospitalsCensus2006.Hospitalisationratesforschizophreniaby areas. Ratesper100,000populationaged16yearsandover. Irish PsychiatricUnitsandHospitalsCensus2006.HospitalisationratesbyHSEadministrative Irish PsychiatricUnitsandHospitalsCensus2006.Diagnosisbygender. Ratesper100,000
28 26 24 22 41 48 39
Irish Psychiatric Units and Hospitals Census 2006 Irish Psychiatric Units and Hospitals Census 2006 Resident patients. population aged16yearsand over, multipliedby100,000. Rates. Old long-stayin-patient. less thanfiveyears. New long-stayin-patient. March 2006). Length ofstay. hospitals. transfer tootherunitsandhospitals,orformedicalsurgicalpurposeswhilestill‘onthebooks’ofpsychiatric (31 March2006).Theywerecalculatedbysubtractingdateofadmissionfromthecensusdate,includingtimespenton In-patient days (ICD-10) (WHO,1992). ICD-10 Research Board(MSRB). The Boardarosefromtheamalgamationoftwoformerbodies,MedicalResearchCouncilandMedico-Social and promotes,assists,commissionsconductsmedical,health,epidemiologicalhealthservicesresearchinIreland. Health ResearchBoard(HRB). Census ofPopulation2002(CentralStatisticsOffice,2003a)ispresentedinChapter1. which theynormallyresided.AmapoutliningeachHSEadministrativeareaanditsrespectivepopulationaccordingtothe hospital administeredbythatarea.Dataonpatientsadmittedandresidentinprivatehospitalswerereturnedtothearea in tabulations relatingtoHSEareaswerecalculatedirrespectiveofwhetherornotthepatientwasresidentinaunit to allocatethepatientcorrespondingHealthServiceExecutivearea,andresidentwasratedaccordingly. Thus, Health ServiceExecutive(HSE)area. population aged15yearsandover;thereforecaremustbeexercisedwhencomparingratesacrosscensusyears. years (whereavailable).Itmustbenotedthatallcensusreportspriorto2001wereratedthetotalpopulation,or some instancescomparisonsaredrawnbetweenthepsychiatricin-patientcensusdatafor2001andthoseother The detailedresultsofthe2006CensusPopulationwerenotavailableattimeproductionthisreport.In Population (CentralStatisticsOffice,2003a,2003b,2003c).Alldatawereratedtothepopulationaged16yearsandover. Computation ofrates. and childadolescentservices. hospitals, communityresidencesandhomevisitsacrossgeneraladultpsychiatry, psychiatryoflaterlife,liaison Activity at COMCAR. serves thecountryasawhole. Central MentalHospital. Age. Glossary Ageoncensusnightwascalculatedbysubtractingthepatient’s dateofbirthfromthecensus(31March2006). Ratesper100,000population aged16yearsandoverwerecalculatedbydividingthepopulation bytheIrish ThediagnosticgroupsinthisreportarebasedontheWHOInternationalClassificationofDiseasescategories COM COMCAR isaHRBsystemwhichdesignedtocapturementalhealthinformationatcommunitylevel. Lengthofstayoncensusnightwascalculatedbysubtracting thedateofadmissionfromcensus(31 In-patients dayswerethenumberofspentinhospitalfromdateadmissiontocensus munity Residentpatientswereall inhospital‘onthebooks’oncensusnight. Theratesaccompanyingnumericaldatainthisreportwerecalculatedusingthe2002Censusof CAR Anoldlong-stayin-patientisonewhohasbeeninhospital continuously forfiveyearsormore. TheCentralMentalHospital,DundrumisadministeredbytheDublinMid-LeinsterHSEbut Anewlong-stayin-patientisonewhohasbeeninhospitalcontinuously foroneyearormorebut e levelinthefollowingservicecomponentsarerecorded:out-patientclinics,daycentres, The HealthResearchBoardwasestablishedin1986(underStatutoryInstrumentNo279) Theaddressfromwhicheachpatientwasadmittedtoaunitorhospitalused
Irish Psychiatric Units and Hospitals Census 2006 10 Irish Psychiatric Units and Hospitals Census 2006 widowed, grandparentsetc),theywereassignedtotheunknowngroup. such persons(students/orengagedinhouseduties)werenotmembersofafamilyunitand/orlivingalone(e.g. in houseduties,theoccupationofheadhousehold/spouse/guardianwasusedtodeterminesocio-economicgroup.If occupation, ortheirformeroccupationwherethepatientwasunemployedretired.Ifastudentengaged Central StatisticsOffice,2003b;2003c).Socio-economicgroupwasdeterminedbyaperson’s of OccupationstheCentralStatisticsOffice(CSO)inCensusPopulation2002(CentralOffice,2003a; Socio-economic group. Patients wereallocatedtooneof11socio-economicgroups(SEGs)accordingtheClassification 11
Irish Psychiatric Units and Hospitals Census 2006 10 Irish Psychiatric Units and Hospitals Census 2006 Ireland increasedby8.1percentinthefouryearperiod2002-2006ratesreportedherewillnotreflectthisincrease. Theratepertotalpopulation was58.2per100,000. Theratepertotalpopulationwas28.3 per100,000. Theratepertotalpopulationwas86.5 per100,000. economic groupswiththeexception ofemployersandmanagers. years agegroupto4.4forthe16–19-yearsgroup.Schizophrenia hadthehighestrateofhospitalisationamongallsocio- highest rateofhospitalisationamongallagegroups,withrates rangingfrom88.4per100,000populationforthe65–74 was twicethatofthefemalerate(i.e.3.2foralcoholicdisorders and5.5forintellectualdisability).Schizophreniahadthe population forfemales.Themalerateofhospitalisation both alcoholicdisorders(7.7)andintellectualdisability(11.2) Males hadahospitalisationrateforschizophreniaof49.4per 100,000populationcomparedtoarateof27.8per followed byotherandunspecified,at20.4;depressivedisorders, at16.2,andmania,9.1. Patients withadiagnosisofschizophreniahadthehighestrate ofhospitalisation,at38.4per100,000population;theywere disorder; 8%hadadiagnosisofmania,and7%each diagnosis oforganicmentaldisorderorintellectualdisability. Over one-third(34%)ofallresidentsoncensusnighthada diagnosis ofschizophrenia;15%hadadepressive higher hospitalisationratethanfemalesforallsocio-economicgroupswiththeexceptionofprofessionals. classified as‘unknown’or‘unspecified’thusmakingitimpossibletoassignthemasocio-economicgroup.Maleshad a followed bytheunskilledgroup,at249.9,andfarmers,82.7.However, itmustbenotedthat51%ofoccupationswere Agricultural workershadthehighestrateofhospitalisationoncensusnight,at264.4per100,000population;theywere males, at35.0per100,000. males hadthehighestrateofhospitalisation,at205.8per100,000population.Thiswasalmostsixtimesthatmarried Two-thirds ofpatientsoncensusnightweresingle;18%married;7%widowed,and1%divorced.Single Hospitalisation ratesforallagegroupshavedeclinedoverthepast40years. at 292.5per100,000;theywerefollowedbythe65–74-yearsagegroup,224.8,and55–64years174.1. 24–44 years,and6%wereunder25yearsofage.The75overagegrouphadthehighestratehospitalisation, 100,000 totalpopulation.Onethirdofresidentswereaged65yearsandover;37%45–64years;25% hospitalisation rateformalesbasedonthe2006totalpopulationofIrelandwas87.8,whilethatfemales72.3per population aged16yearsandover;thiscomparedtoahospitalisationrateof99.5per100,000forfemales.The Males accountedforoverhalf(55%)ofallpatientsoncensusnight,withahospitalisationrate124.7per100,000 previously was53.9per100,000totalpopulation. hospitalisation forfirst-timepatientsbasedonthe2006populationwas26.2whilethatwhohadbeenadmitted The hospitalisationratebasedonthe2006totalpopulationofIrelandwas80.0per100,000 rate forthosewhohadbeenadmittedpreviously(75.3per100,000) 19,801 in1963to3,3892006.Therateofhospitalisationfirst-timeresidents(36.6per100,000) reduction of83%inthenumberspatientsresidentIrishpsychiatricunitsandhospitals,withfallingfrom represents ahospitalisationrateof111.9per100,000populationaged16yearsandover On 31March2006thenumberofpatientsresidentinIrishpsychiatricunitsandhospitalstotalled3,389;thisfigure the 2002Censuswehave alsoratedournumbersto2006all-agedpopulationwhereappropriate. gender withagenotbecomingavailableuntil2007. Inadditiontopresentingdatabyandothervariablesderivedfrom our reportthepreliminaryresultsof2006PopulationCensusbecameavailable.Thesewerelimitedtonumbersand census. Theratespresentedinthisdocumenthavebeenbasedonthe2002CensusofPopulation.Shortlybeforefinalising psychiatric unitsandhospitalsoperatingundertheprovisionsofMentalTreatment Act1945wereenumeratedinthis The sixthnationalcensusofIrishpsychiatricunitsandhospitalswascarriedouton31March2006.Allpatientsresidentin Summary . . Since1963therehasbeena
As thepopulationin waslowerthanthe 11
Irish Psychiatric Units and Hospitals Census 2006 12 Irish Psychiatric Units and Hospitals Census 2006 in-patient days,at34%,andhad thelongestaveragelengthofstayoncensusnight,at68 days. hospital for25yearsormoreon censusnight.TheHSEDublinMid-Leinsteraccountedfor thelargestproportionof figure forpatientsresidentin the HSESouthareawas53%.Sixteenpercentofthoseresident intheHSE West hadbeenin in theHSEDublinMid-Leinsterwerelong-stay(i.e. hospital foroneyearormoreoncensusnight);thecomparable census night;thecomparablefigureforpatientsresidentin the HSESouthwas36%.Incontrast,37%ofpatientsresident Almost half(48%)ofpatientsresidentintheHSEDublinMid-Leinster hadbeeninhospitalforlessthanthreemonthson this wasfollowedbytheHSEDublinNorth-East,at24.7,and theHSEDublinMid-Leinster, at20.2. and HSEWest. Therateofnon-voluntaryhospitalisation washighestintheHSESouth,at35.7per100,000population; patients, at27%;thiswasfollowedby22%fortheHSEDublin North-Eastand19%eachintheHSEDublinMid-Leinster 33.1 per100,000populationintheHSEDublinMid-Leinster. TheHSESouthhadthehighestproportionofnon-voluntary Diagnostically, schizophreniahadhighestratesinallHSEareas.Ratesranged from43.0per100,000intheHSESouthto patients residentintheHSESouthareawereaged75yearsandoveroncensusnight. followed bytheHSEDublinNorth-Eastarea,at32%,andMid-Leinster30%.One-fifthof The HSESouthareahadthehighestproportion(40%)ofelderlypatientsi.e.thoseaged65yearsandover;thiswas area hadthelowestrateofhospitalisation,at96.4per100,000population. followed bytheHSEDublinNorth-Eastarea,at113.0,andMid-Leinster105.7.TheWest The HSESouthareahadthehighestrateofhospitalisationoncensusnight,at131.0per100,000population;thiswas two hadbeenhospitalisedforbetweenoneandweeks. childhood andadolescence.Threechildrenhadbeeninhospitalforbetweenonethreemonthsoncensusnight,while census night.Two childreneachhadadiagnosisofdepressivedisorder, neurosisandbehaviouralemotionaldisorderof Three ofthesechildrenwereaged8years,13yearsand14respectively;three15two16on On 31March2006thenumberofchildrenresidentinchildren’s centrestotalledeight(i.e.fourmaleand female). of developmentdisorders,at141.5days,andthosewithadiagnosisorganicmental140.4days. intellectual disabilityhadthelongestaveragelengthofstay, at165.1days;theywerefollowedbyresidentswithadiagnosis disorders, at18%;depressive16%,andorganicmental11%.Residentswithadiagnosisof Schizophrenia accountedforthelargestproportionofin-patientdays,at33%;thiswasfollowedbyotherandunspecified years ormore. intellectual disabilityhadbeenhospitalisedforovertenyearsoncensusnight,while45%25 neuroses hadbeeninhospitalforbetweenoneandthreemonthsoncensusnight.Two-thirds ofthosewithadiagnosis been inhospitalforlessthanoneweekoncensusnight.Incontrast,one-fifthofthosewithdepressivedisordersand Over one-fifth(21%)ofthosewithadiagnosisalcoholicdisordersand23%otherdrughad of thoseinhospitalforfiveyearsormoreoncensusnightwereaged65andover. 29% ofallresidentswereoldlong-stayi.e.hadbeeninhospitalforfiveyearsormoreoncensusnight.Forty-sevenpercent Forty-six percentofallresidentswerelong-staypatientsi.e.theyhadbeeninhospitalforoneyearormoreoncensusnight; 100,000 totalpopulation. voluntary rateformalesbasedonthe2006totalpopulationofIrelandwas20.8whilethatfemales14.2per The non-voluntaryratebasedonthe2006totalpopulationofIrelandwas17.6per100,000population.non- their firsteveradmission,and23%ofthosewhowereonsecondorsubsequentnon-voluntary. voluntary hospitalisation,at29.5per100,000comparedtoarateof19.8forfemales.Twenty-one percentofthoseon per centofmaleswerenon-voluntary;thecomparableproportionforfemaleswas20%.Maleshadahigherratenon- Twenty-two percentofresidentsoncensusnightwerenon-voluntary, arateof24.6per100,000population.Twenty-four
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Irish Psychiatric Units and Hospitals Census 2006 12 Irish Psychiatric Units and Hospitals Census 2006 neighbouring Western Europeancountries. The numberofpersonsinin-patientcareproportionatetothepopulationIrelandisverysimilarthatprevailing Vision forChange provide foracuteillness,inmostcasesseparatefree-standingadmissionunits.However, currentpolicyassetoutin year’s time.Itshouldbeborneinmindthatsomeofthesepsychiatrichospitalsaswellcateringforthelong-stayalso hospital psychiatricunits)willhavediminishedtosuchadegreethatthesehospitalsshouldbeinpositionclosefive and mortality, itispredictedthatthenumbersofpatientscurrentlyinpublicpsychiatrichospitals(asdistinctfromgeneral On thebasisofgreatlyreducednumbersnowenteringlong-stayin-patientcare,currentadmissionanddischargerates non-voluntary; thecomparablefigureforprivatehospitalswas7%. one-quarter (26%)ofthoseresidentingeneralhospitalpsychiatricunitsand23%hospitalswere aged 65yearsorover;thiscomparedtoprivatehospitalswith36%,andgeneralhospitalpsychiatricunits16%.Over from 90%in1981to52%2006.Oncensusnight,psychiatrichospitalshadthelargestproportion(42%)ofpatients 23% in2006.Therehasbeenacorrespondingdecreasetheproportionofresidentspsychiatrichospitals;thisfallen considerable increaseintheproportionofresidentsgeneralhospitalpsychiatricunits;thishasrisenfrom3%1981to of patientswereresidentingeneralhospitalpsychiatricunitsand17%privatehospitals.Therehasbeena Psychiatric hospitalsaccountedfor52%ofallpatientsinpsychiatricin-patientcareoncensusnight;anadditional23% isthatallacutecareshouldbedeliveredingeneralhospitalpsychiatricunits. A 13
Irish Psychiatric Units and Hospitals Census 2006 14 Irish Psychiatric Units and Hospitals Census 2006 15
Irish Psychiatric Units and Hospitals Census 2006 14 Irish Psychiatric Units and Hospitals Census 2006 b a Tabletype. 1.1Hospital the Central Mental Hospital, Dundrum are included in this report. A breakdown of hospital type is presentedData inon Tablepatients resident 1.1. in 56 general hospital psychiatric units, psychiatric hospitals, private hospitals, children’s centres and Data coverage More detailedanalysisofthedataisavailableonrequest. decline ofthelong-staypopulationandmakespredictionsforfuturein-patientnumbers. International comparisonsarepresentedanddiscussedinChapter2;theconcludingchapterofreportoutlines population aged15yearsandover. are per100,000populationaged16yearsandover. Comparativedataforpreviouscensusyearsareratedper100,000 1991 (MoranandWalsh, 1992)and2001(DalyWalsh, 2002).Ratesreportedforthe2006and2001censusdata census datafor2006and1963(Walsh, 1971);1971(O’HareandWalsh, 1974);1981(O’HareandWalsh, 1983); administrative areas,hospitaltype,andindividualpsychiatricunitshospitals.Comparisonsaremadebetweenthe National findingsarepresentedinChapter2;thesefollowedbychaptersonHealthServiceExecutive in thecensus. (Department ofHealth,1945).Allpatients‘onthebooks’inhospitalsandunits,includingthoseonleave,wereenumerated 31 March2006inIrishpsychiatricunitsandhospitalsoperatingundertheprovisionsof The IrishPsychiatricUnitsandHospitalsCensus2006reportprovidesinformationonpatientsresidentatmidnight hospitals inIrelandshouldbeclosed. A Vision forChange development ofacutepsychiatricunitsingeneralhospitals,andthishassincebeenreiteratedtherecentpolicydocument by the community residentialaccommodation.Thechangefrominstitutionalsettingstocommunity-basedserviceswasadvocated move awayfromtraditionalpsychiatrichospitalstomorecommunity-basedfacilitiessuchasdayhospitals,centresand There havebeenmanychangesintheIrishpsychiatricservicessincefirstcensusof1963,mostnotably on 31March2006,afteranintervalofjustfiveyears. impact ofsuchchangesonin-patientresidentnumbersandcharacteristicswasneeded;accordingly, acensuswascarriedout to theacceleratedmoveprovisionofcommunitypsychiatricservices,itwasfeltthatanearlierappreciation is thelatestinaseriesofcensusesfirstcarriedout1963,anddecenniallythereafter1971,1981,19912001.Due We arepleasedtopresentthisreportonthesixthnationalcensusofin-patientsinIrishpsychiatricunitsandhospitals; 1. Introduction andbackground information Total St Joseph’s Intellectual DisabilityService Carraig Mór, Cork Central MentalHospital,Dundrum Private hospitals Children’s centres Psychiatric hospitals General hospitalpsychiatricunits type Hospital Carraig Mórisanintensivecareand rehabilitationunit. St Joseph’s IntellectualDisability ServiceislocatedatStIta’s Hospital,Portrane. Commission ofEnquiryonMentalIllness a (DepartmentofHealthandChildren,2006),whichrecommendsthatallremainingpsychiatric b (DepartmentofHealth,1966).TheCommissionalsoenvisagedthe Mental Treatment Act,1945 Number 55 22 22 1 1 1 6 2
15
Irish Psychiatric Units and Hospitals Census 2006 16 Irish Psychiatric Units and Hospitals Census 2006 reflect ongoing activitiesinIrishpsychiatric units andhospitals.Thisinformation isavailableintheannual publication, The censusdatareflectthesituation inpsychiatrichospitalsandunitsataparticularpoint intimeanddonottherefore group impossible.Thisshould beborneinmindwheninterpretingthefindingsforthissection. Over half(51%)ofreturnsfor occupationwereunknownorunspecified,thusmakingassignment toasocio-economic renewed effortstoenticetheseunitsandhospitalsassigna provisionaldiagnosistopatientsonadmission. category anditisunclearhowmanyofthemwouldbeassigned tootherdiagnosticcategoriesondischarge.We aremaking ‘Other andunspecified’diagnosticcategory. Eighteenpercentofpatients residentoncensusnightwereassignedtothis resident oncensusnightinthesehospitalswerecategorisedas havinganunspecifieddiagnosisandwereassignedtothe A numberofunitsandhospitalsdonotassignadiagnosisto patientsuntiltheyaredischarged.Thus,whowere Limitations Table 1.2 retardation’, we use the term ‘intellectual disability’, to accord with current Irish usage. and emotional disorders, although these admissions were very few in number. Finally, whereas ICD 10 uses the term ‘mental that admissions of persons over 16 years of age were included in the categorisation of childhood and adolescence behavioural Act (Department of Health and Children, 2001) in its entirety, this will be extended to 18 years of age. It is therefore the case stands, childhood and adolescence extends only to 16 years of age. With the operationalisation of the 2001 Mental Health to these disorders and are not presented as disorders of childhood and adolescence. As current mental health legislation schizophrenic, depressive and manic conditions arising in childhood and adolescence are included in the ‘F’ codes appropriate three categories were included with the neuroses and personality groupings. However, it should be pointed out that organic, disorders and behavioural and emotional disorders of childhood and adolescence as individual entities; previously these codes relate to Mental and Behavioural Disorders). The new diagnostic groupings present eating disorders, development This year’s report sees the re-organisation into new groupings of the ICD diagnostic code, 10 Diagnosis electronically. AsampleoftheformusedtocollectdataispresentedinAppendix1. personnel codedandprocessedthedata.ElectronicreturnswerereceivedfromhospitalswhichsubmitdataforNPIRS to theHealthResearchBoard(HRB)forallpatientsresidentintheirfacilitiesatmidnighton31March2006.HRB the NationalPsychiatricIn-patientReportingSystem(NPIRS)completedandreturnedspeciallydesignedcensusforms Data forthecensuswerecollectedbothmanuallyandelectronically. Hospitalswhichnormallyreturndatamanuallyfor procedureData collection 6. 7. 11. Developmentdisorders 10. Intellectualdisability 1. diagnosticgroup ICD-10 13. 12. 9. 8. 3. 2. 5. 4. Mania Neuroses Organic disorders Other andunspecified Personality andbehaviouraldisorders Eating disorders Other drugdisorders Alcoholic disorders Depressive disorders Schizophrenia, schizotypalanddelusionaldisorders and adolescence Behavioural andemotionaldisordersofchildhood
ICD-10 diagnosticgroups. ICD-10 F30, F31.0,F31.1,F31.2,F31.6,F31.7,F31.8,F31.9,F34.0 F31.3, F31.4,F31.5,F32,F33,F34.1,F34.8,F34.9 th edition (of which the ‘F’ F38, F39,F51-54,F59,F99 F11-19, F55 ICD-10 Code ICD-10 F20-F29 F90-98 F80-89 F70-79 F60-69 F40-48 F00-09 F50 F10 17
Irish Psychiatric Units and Hospitals Census 2006 16 Irish Psychiatric Units and Hospitals Census 2006 Division, HealthResearchBoard,[email protected] +35316761176 roll-out willbeincountyDonegal(29sites).Forfurtherinformation pleasecontactRachelFlynn,MentalHealthResearch NPIRS/COMCAR willbeimplementedinaphasedapproach andithasbeenagreedthatNPRIS/COMCARfirstphase implemented inapproximately56psychiatrichospitals/unitsandupto1000communitycarefacilities. and ICTDirectoratetoensurethenationalrolloutofNPRIS/COMCAR.ItisenvisagedthatNPIRS/COMCARwillbe facilities. TheHealthResearchBoardisworkingincollaborationwiththeServiceExecutive(HSE)–Mental NPIRS/COMCAR willrecordandreportdatainrealtimeonmentalhealthactivitybothhospitalcommunitycare selected andappointedasoftwarecompanytodeveloptheNPIRS/COMCARwebbasedapplication. COMCAR andNPIRSwouldbecomeasingleintegratedweb-basedapplication.AfterselectivetenderprocesstheHRB day centresandhospitalswasimplementedonapilotbasisinnumberofsites.In2005itdecidedthatboth (COMmunity CARe).COMCARwasdesignedtorecordactivityatcommunitycarelevel,includingoutpatientclinics, In 2003inresponsetochangingpatternsofpatientcare,theHRBdevelopedaMicrosoftAccessdatabasecalledCOMCAR NPIRS/COMCAR –Adatabasetocapturebothin-patientandcommunitycarementalhealthservicesactivityinIreland HRB COMCARdatabase,detailsofwhichareavailablebelow. separately. It isenvisagedthatdataonadditionalcommunitypsychiatricfacilitieswillbeavailableinthefuturefrom community residenceswasalsocarriedoutbytheHRBon31March2006,andresultsofthatcensuswillbepublished local levelsasattemptedinChapter6.Whilethisreportpresentsdataonin-patientfacilitiesonly, acensusofhigh-support international comparisons.Theyallowustopredictpossiblefuturebedandhospitalrequirementsatbothnational The censusdataareinvaluablefortheplanninganddevelopmentofmentalhealthservices,aswellmaking figure of4,234,925(CentralStatisticsOffice,2006). thus ratesreportedwillnotreflectthisincrease.InternationalcomparisonsaremadeinChapter2usingthetotalpopulation population intheseinstances.TheIrelandincreasedby8.1percentthefouryearperiod2002-2006and the preliminaryfiguresfor2006CensusofPopulationwereavailable,rateshavebeenreportedper100,000total The fullresultsofthe2006CensusPopulationwerenotavailableattimepublicationreport.Where The ratesusedinthisreportarebasedontheCensusofPopulation2002(CentralStatisticsOffice,2003a,2003b,2003c). area. distort therealpositionrelatingtosomecatchments.Henceforthispublicationwehavenotpresentedratesbycatchment exclusively St.Stephen’s providedresidentialcarefortheentireCorkcounty. Thereforeratesbasedonnumbersresident North Lee,14fromWest Corkandasmallernumberfromelsewhere.ClearlyratherthanbeingresponsibleforNorth catchment area,outof137patientsresidentoncensusnightonly60werefromNorthCork,with51being become questionableincertaincatchmentsareas.Forexample,StStephen’s Hospital,GlanmireservicingtheNorthCork in aparticularinpatientunitorhospitaloriginatedfromanaddressthatcatchment.Thevalidityofthisassumptionhas In earlier census reports we have provided hospitalisation rates for each catchment based on the assumption that all patients available data. Activities ofIrishPsychiatricUnitsandHospitals , withthe2005report(Daly et al ext , 2006)havingthemostrecently 214. 17
Irish Psychiatric Units and Hospitals Census 2006 18 Irish Psychiatric Units and Hospitals Census 2006 NPIRS/COMCAR End-User C ommunity Care HR Ty B -MH pe A–Hospital/
Web application RD Fa cilitie
s G G VPN VPN We NP cent IR b Fr ra S/ l databse CO on MC t t AR En d G VPN End-User C ommunity Care Local Ser NP IR Data Se S/ CO Ty ve pe B–Hospital/ MC r t AR Fa cilitie s 19
Irish Psychiatric Units and Hospitals Census 2006 18 Irish Psychiatric Units and Hospitals Census 2006 3 Theratepertotal populationwas58.2per100,000. Theratepertotalpopulationwas28.3 per100,000. Theratepertotalpopulationwas86.5 per100,000. per 100,000totalpopulation. The hospitalisationrateformalesbasedonthe2006totalpopulation ofIrelandwas87.8,whilethatforfemales72.3 half ofallin-patientsineachcensusyear(Table 2.2). There hasbeenlittlechangeinthegenderbreakdownofin-patients overthepast40years,withmalesrepresenting 124.7 per100,000populationaged16yearsandover;thecomparable rateforfemaleswas99.5per100,000(Table 2.12). Males accountedforoverhalf(55%)ofallin-patientsoncensus night(Table 2.2),representingahospitalisationrateof Gender andage c MentalHealthCommission,2006. b MentalHealthCommission,2005. a MSRB/HRBCensuscompletedon31Marcheachyear. Table psychiatric 2.1Irish in-patient numbers196 3-2006. Daly andWalsh, 2002). care asanalternativetolong-stayinstitutionalcare,haveallplayedasignificantroleinthisdecline(Walsh andDaly, 2004; non-replacement bynewlong-staypatientsinpsychiatrichospitalsandunits),tandemwiththegrowthofcommunity 83% since1963andareductionof22%2001.Themortalitydischargethelong-staypopulation(andtheir with thenumberofin-patientsdroppingfrom19,801in1963to3,3892006(Table 2.1).Thisrepresentsareductionof The past40yearshaveseenaconsiderabledeclineinthenumberofpatientsresidentIrishpsychiatricunitsandhospitals, population ratherthanthoseaged16yearsandover. those ofagewerenotavailableatthetimepublicationthisreportandhenceusefiguresfortotal admitted previouslywas53.9per100,000totalpopulation.Thefullresultsofthe2006CensusPopulationincluding of hospitalisationforfirst-timepatientsbasedonthe2006populationwas26.2,whilethatwhohadbeen The hospitalisationratebasedonthe2006totalpopulationofIrelandwas80.0per100,000population; admitted previously. Theserateswerebasedonthe2002CensusofPopulation. lower hospitalisationrate,at36.6 represents ahospitalisationrateof111.9per100,000populationaged16yearsandover.First-timein-patientshad As of31March2006thenumberpatientsresidentinIrishpsychiatricunitsandhospitalstotalled3,389;thisfigure 2. National findings 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 Year a 15,471 15,856 16,661 16,403 16,802 17,218 17,841 18,084 18,641 18,989 19,801 Number 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 Year per100,000;thiscompareswitharateof75.3100,000 a 12,484 12,802 13,428 13,984 13,342 13,838 13,968 14,352 14,473 14,967 15,156 Number Year 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 a 10,621 11,643 12,097 5,327 5,581 5,806 6,130 8,207 7,334 7,897 9,500 Number Year 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 3 forpatientswhohadbeen a c b a Number 3,389 3,475 3,556 3,658 3,891 4,321 4,230 4,469 4,820 4,817 5,212 19
Irish Psychiatric Units and Hospitals Census 2006 20 Irish Psychiatric Units and Hospitals Census 2006 Table Psychiatric 2.3Irish UnitsandHospitals Census 1971-2006. Age groups. Rates per100,000 population. 224.8, whiletheratefor55–64yearsagegroupfellfrom1,313.3to174.1. 1,735.7 per100,000populationin1971to292.52006;theratefor65–74yearsagegroupfellfrom1,471.7 for allagegroupshavedeclinedconsiderably. Thehospitalisationratesforthe75yearsandoveragegroupdeclinedfrom Table 2.3presentsthehospitalisationratesforeachofthesegroupsinsuccessivecensusyear. Hospitalisationrates 18 yearsofageinhospitaloncensusnightto30. additional eightpatientswereresidentinchildren’s centres(seeChildren’s centressection)bringing thetotalnumberunder There were22personsunder18yearsofageresidentinunitsandhospitalsoncensusnight(seealsoChapter4).An 55–64 years age group, at 174.1 per 100,000. The 16–19 years age group had thehighest lowest hospitalisation rate, at 14.7 perrate, 100,000 at 292.5 population. per 100,00 population; they were followedand by6% thewere 65–74 aged yearsunder age25 yearsgroup, (Table at 224.8, and2.12). the Sixteen per cent of in-patientsOne-third were ofaged in-patients 75 years andwere over. aged 65 years This and group over had on thecensus night; 37% were aged 45–64 years; 25% were aged 25–44 years, 1974, 1983;MoranandWalsh, 1992; DalyandWalsh, 2002). Source: MSRB/HRB census completed on 31 March 1963, 1971, 1981, 1991 and 2001. (Walsh, 1971; O’Hare and Walsh, married and widowed females had higher hospitalisation rates compared to their married and widowed male 35.0counterparts. per 100,000. The hospitalisation rate for single females, at 145.9, was three times that of marriedSingle females males (47.8). had the Both highest rate of hospitalisation, at 205.8 per 100,000. This was almost six times thatpersons, of married at 125.5, males, and atwidowed persons, at 119.3. Married persons had the lowest rate of hospitalisation,2.13). at 41.1 Single per persons100,000. had the highest rate of hospitalisation, at 177.8 per 100,000 population; they wereTwo-thirds followed by divorced of in-patients on census night were single; 18% were married; 7% were widowed, and 1% were divorced (Table status Marital a Ratesper100,000populationaged16yearsandover. 1974, 1983;MoranandWalsh, 1992;DalyandWalsh, 2002). Source: MSRB/HRB census completed on 31 March 1963, 1971, 1981, 1991 and 2001. (Walsh, 1971; O’Hare and Walsh, Table Psychiatric 2.Irish UnitsandHospitals Census 1963-2006. Gender. Numberswithpercentages. 2006 2001 1991 Under 15years 75 yearsandover 65 -74years 55 -64years 45 -54years 35 -44years 25 -34years 20 -24years 15 -19years 1981 1971 1963 Number 1,471.7 1,313.3 1,735.7 10,588 Males 967.1 760.0 483.9 266.0 108.7 23.2 1,859 2,395 4,486 7,737 9,242 1971 54.9 55.4 54.7 55.3 55.5 53.5 1,229.3 1,036.8 1,608.6 % 792.4 517.3 275.2 142.7 46.0 1981 7.4
1,048.9 745.1 566.3 390.9 241.8 138.9 69.1 31.7 1991 4.0 Number Females 1,530 1,926 3,721 6,247 7,419 9,213 75 yearsandover 65 –74years 55 –64years 45 –54years 35 –44years 25 –34years 20 –24years 16 –19years Under 16years 45.1 44.6 45.3 44.7 44.5 46.5 % 454.9 345.5 256.7 168.9 125.2 2001 74.2 53.2 32.9 Total
a - Number 13,984 16,661 19,801 3,389 4,321 8,207 2006 292.5 224.8 174.1 132.6 85.8 57.2 45.7 14.7 a - 21
Irish Psychiatric Units and Hospitals Census 2006 20 Irish Psychiatric Units and Hospitals Census 2006 Table Psychiatric Irish UnitsandHospitals Census 1963-2006. 2.4 status. Marital Percentages withrates. consistently higherratesofhospitalisationthanmarried,widowedordivorcedpersons(Table 2.4). Single personshaveaccountedforbyfarthelargestproportionofin-patientsineachsuccessivecensus,showing Table Psychiatric 2.5Irish UnitsandHospitals Census 1963-2006. Socio-economic group. Rates per100,000 population. groups showedareductionofover74%inhospitalisationratesbetween1963and2006. employees) andemployersmanagers,bothofwhichgroupshadthelowesthospitalisationrates.Allsocio-economic census year;thistablealsoshowsratesforothergroupsincludingownaccountworkers(self-employedpersonswithout unskilled grouphadthehighestrate.InTable 2.5thehospitalisationratesforthesetwogroupsarecomparedeach highest hospitalisationrateinallcensusyearswiththeexceptionof2001,whenpatternwasreversed;thatyear workers (formerly‘otheragriculturalworkers’)hadthehighesthospitalisationrate.Theunskilledgroupsecond Table 2.5presentsthehospitalisationratesforsocio-economicgroupsineachsuccessivecensus.Traditionally, agricultural for allsocio-economicgroupswiththeexceptionofhigherprofessionals. to psychiatricunitsandhospitalsovermanyyears(Daly group. Thehigherrateofhospitalisationamongtheunskilledgrouphasbeenconsistentlynotedinfiguresforadmissions of in-patientswereclassifiedas‘unknown’or‘unspecified’,thusmakingitimpossibletoassignthemasocio-economic unskilled group,at249.9,andfarmers,82.7(Table 2.15).However, itshouldbenotedthattheoccupationsof51% Agricultural workershadthehighestrateofhospitalisation,at264.4per100,000population;theywerefollowedby Socio-economic group 1974, 1983;MoranandWalsh, 1992; DalyandWalsh, 2002). Source: MSRB/HRB census completed on 31 March 1963, 1971, 1981, 1991 and 2001. (Walsh, 1971; O’Hare and Walsh, b RevisedCSOclassification of occupations(CSO,1998). a Malesonly. Returnsforfemales1963 weredeemedtobeunreliable. 1974, 1983;MoranandWalsh, 1992;DalyandWalsh, 2002). Source: MSRB/HRB census completed on 31 March 1963, 1971, 1981, 1991 and 2001. (Walsh, 1971; O’Hare and Walsh, Lower professional Higher professional Other agricultural/agriculturalworkers Farmers Salaried employees/ownaccountworkers Employers andmanagers Other non-manual Intermediate non-manual/Non-manual Semi-skilled manual Skilled manual/Manualskilled Unskilled manual Married Single Divorced Widowed 1963 12.6 82.1 5.3 - 11.8 82.2 1971 5.8 - 13.0 79.5 1981 6.5 - % 77.2 14.8 1991 7.7 - 2001 17.0 69.0 0.6 7.6 et al,
2006).Maleshadahigherhospitalisationratethanfemales 3,465 1963 664 2006 736 123 380 762 144 508 481 944 780 17.8 65.8 1.3 6.6 a 1,771.7 428.8 450.8 476.6 183.1 932.2 179.6 454.1 218.5 617.2 1963 264 1971 - - - - 203.0 782.4 578.8 1,206.3 1971 333.1 651.2 278.5 160.7 838.9 285.4 175.2 65.8 - 1981 276 397 146.6 572.0 512.6 1981 Rates - 109.7 621.9 277.5 26.9 117.4 158.6 83.8 77.3 279.4 583.5 138.6 1991 314.7 340.3 93.2 1991 - 314.3 49.9 252.8 111.8 30.4 75.8 91.8 61.0 46.9 2001 5.8 279.8 255.4 177.3 2001 54.1 b 35.5 264.6 13.2 48.8 69.1 63.3 249.9 82.0 177.8 125.5 119.3 2006 2006 7.4 82.7 41.4 21
Irish Psychiatric Units and Hospitals Census 2006 22 Irish Psychiatric Units and Hospitals Census 2006 of intellectualdisabilitywas7%in2006,representingareduction ofjust2%between2001and2006. However, theproportionhasdecreased from 53%in1963to34%2006.Theproportionofin-patientswithadiagnosis Schizophrenia hasconsistentlyaccountedforthelargestproportion ofin-patientsineachsuccessivecensus(Table 2.6). the unskilled. disability), andamonglowerprofessionals,employersmanagers, non-manualworkers,manualskilled,semi-skilledand disorders hadthesecondhighesthospitalisationratesamong farmers,agriculturalworkers(alongwithintellectual 2.18). Ratesforschizophreniarangedfrom137.6agricultural workersto2.9forownaccountworkers.Depressive Schizophrenia hadthehighestrateinallsocio-economicgroups withtheexceptionofemployersandmanagers(Table group, while rates for organic mental disorders were second highest among the 75 years and over age group.for depressive disorders were second highest among the 16–19-years age group, the 55–64-years group and populationthe 65–74-years for the 65–74-years age group to 4.4 per 100,000 for the 16–19-years age group (Table 2.17).Schizophrenia Hospitalisation accounted ratesfor the highest rate of hospitalisation among all age groups, with rates ranging from 88.4 per 100,000 Figure 2.1 intellectual disability(11.2)wastwicethatofthefemalerate(3.2foralcoholicdisordersand5.5disability). 27.8 per100,000(Figure2.1andTable 2.16).Themalerateofhospitalisationforbothalcoholicdisorders(7.7)and Males hadahospitalisationrateforschizophrenia,at49.4per100,000population;thecomparablefemaleswas depressive disorders,at16.2,andadiagnosisofmania,9.1. population; theywerefollowedbypatientswithadiagnosisofotherandunspecifieddisorders,at20.4, (Table 2.16).Patientswithadiagnosisofschizophreniahadthehighestratehospitalisation,at38.4per100,000 disorders; 8%hadadiagnosisofmania;7%eachorganicmentaldisordersorintellectualdisability Over one-third (34%) of all in-patients on census night had a diagnosis of schizophrenia; 15% had a diagnosis of depressive Diagnosis
Organic 10.0 20.0 30.0 40.0 50.0 60.0
Me 0.0
n
tal Diso 16 years andover. Irish PsychiatricIrish UnitsandHospitals Census 2006. Diagnosisby gender. Rates per100,000 population aged Alcoholic Disorders
rder 8.
s 7 5
Other Drug Dis .0 7. 7 3. 0 2
orders 1. Schiz 0 .7
Depressive Disordersophrenia 49.4 27.8 13.718.7
Mani 8.
Pe 9 3
a rson .8
Neur
ality
Ea oses 1.
and Beha t 2 6 ing Di .2
sorder
viou
Beha
ra s 1.
l Disorder 1 0 viou Intellectual Disorder
ra
l and Emotional Dis .9
s
Developmen 2. 7 11.2
s 5.
t 5
Disorder
order 0. 0 5 s of Childhood
s .4 Other and Unspe 0. 3
cified 20.7 20.1 Female Male 23
Irish Psychiatric Units and Hospitals Census 2006 22 Irish Psychiatric Units and Hospitals Census 2006
Table 2.6 Irish Psychiatric Units and Hospitals Census 1963-2006. Diagnosis. Numbers with percentages.
1963 % 1971 % 1981 % 1991 % 2001 % 2006 % Organic psychoses 2,727 13.8 1,817 10.9 1,427 10.2 740 9.0 317 7.3 Organic mental disorders 235 6.9 Schizophrenia 10,496 53.0 8,353 50.1 6,182 44.2 3,526 43.0 1,701 39.4 Schizophrenia, schizotypal and 1,163 34.3 delusional disorders Other psychoses - 345 2.1 52 0.4 41 0.5 49 1.1 Manic depressive psychosis 2,545 12.9 2,051 12.3 1,534 11 - - - - Depressive disorders ------1,202 14.6 752 17.4 Depressive disorders 492 14.5 Mania - - - 481 5.9 424 9.8 Mania 275 8.1 Neuroses 968 4.9 555 3.3 798 5.7 422 5.1 146 3.4 Neuroses 58 1.7 Personality disorders 306 1.5 218 1.3 296 2.1 374 4.6 125 2.9 Personality and behavioural 70 2.1 disorders Alcoholic disorders - - 392 2.4 688 4.9 408 5 241 5.6 Alcoholic disorders 164 4.8 Drug dependence - - 21 0.1 20 0.1 20 0.2 56 1.3 Other drug disorders 26 0.8 Mental handicap 2,732 13.8 2,680 16.1 2,170 15.5 962 11.7 392 9.1 Intellectual disability 251 7.4 Eating disorders 18 0.5 Development disorders 13 0.4 Behavioural and emotional 7 0.2 disorders of childhood and adolescence Unspecified 27 0.1 229 1.4 19 0.1 31 0.4 118 2.7 Other and unspecified 617 18.2 Total 19,801 100.0 16,661 100.0 13,984 100.0 8,207 100.0 4,321 100.0 Total 3,389 100.0 Source: MSRB/HRB census completed on 31 March 1963, 1971, 1981, 1991 and 2001. (Walsh, 1971; O’Hare and Walsh, 1974, 1983; Moran and Walsh, 1992; Daly and Walsh, 2002). 23
Irish Psychiatric Units and Hospitals Census 2006 24 Irish Psychiatric Units and Hospitals Census 2006 4 Theratepertotal populationwas58.2per100,000. disorders hadbeeninhospital forlessthanoneweekoncensusnight(Table 2.24).Incontrast, one-fifthofthosewith Over one-fifthofthosewitha diagnosisofalcoholicdisorders(21%)and23%those with adiagnosisofotherdrug hospital forfiveyearsormore wereaged65yearsandover(Table 2.23). night. One-fifthofin-patientshadbeenhospitalisedforten yearsormore.Forty-sevenpercentofthosewhohadbeenin in hospitalforbetweenoneandthreemonths,anadditional 17%hadbeenhospitalisedforuptotwoweeksoncensus were oldlong-stayi.e.hadbeeninhospitalforfiveyearsor more(Table 2.22).Seventeenpercentofin-patientshadbeen Forty-six percentofallin-patientswerelong-stayi.e.theyhad beeninhospitalforoneyearormoreoncensusnight;29% Length ofstay PsychiatricFigure 2 .2 Irish UnitsandHospitals Census 1963 1974, 1983;MoranandWalsh, 1992;DalyandWalsh, 2002). Source: MSRB/HRB census completed on 31 March 1963, 1971, 1981, 1991 and 2001. (Walsh, 1971; O’Hare and Walsh, available ineither1971or1981. while thisproportiondropped,itincreasedbetween2001and2006(Figure2.2).Informationonlegalstatuswasnot Overall, therewasadecreaseintheproportionofnon-voluntaryin-patientsfrom79%1963to22%2006.However, of depressivedisorders(arate2.0)(Table 2.20). diagnosis oforganicmentaldisorders(arate2.5);10%hadamania2.4),and8% Forty percentofnon-voluntaryin-patientshadadiagnosisschizophrenia(arate9.8100,000);10% 100,000 totalpopulation. non-voluntary rateformalesbasedonthe2006totalpopulationofIrelandwas20.8whilethatfemales14.2per The non-voluntaryratebasedonthe2006totalpopulationofIrelandwas17.6per100,000population. or subsequentadmissionwerenon-voluntary(Table 2.21.) 19.8 per100,000.Twenty-one percentofthoseontheirfirsteveradmissionand23%whoweresecond 20%. Maleshadahigherrateofnon-voluntaryhospitalisation,at29.5per100,000;thecomparableforfemaleswas population Twenty-two percentofin-patientsoncensusnightwerenon-voluntary;thisrepresentedarate24.6100,000 Legal status 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 90.0 0.0 4 (Table 2.19).Twenty-four percentofmaleswerenon-voluntary;thecomparableproportionforfemaleswas 21.0 74.6 Vo 10 20 30 40 50 60 70 80 90 luntary 0 83.4 78.0 , 1991, 2001and006. Legal status. Percentages. 79.0 25.3 Non- vo luntar y 16.6 22.0 196 1991 2006 2001 3 25
Irish Psychiatric Units and Hospitals Census 2006 24 Irish Psychiatric Units and Hospitals Census 2006 1974, 1983;MoranandWalsh, 1992;DalyandWalsh, 2002). Source: MSRB/HRB census completed on 31 March 1963, 1971, 1981, 1991 and 2001. (Walsh, 1971; O’Hare and Walsh, Table 2.7 Psychiatric Irish UnitsandHospitals Census 1971-2006. Length ofstay. Numberswithpercentages. continue to decline due to the discharge and death of these patients, and their non-replacement by new long-stay patents. report, 47% of those hospitalised for five years or more were aged 65 years and over. The proportion of long-stay patients will The proportion of old long-stay patients has decreased from 61% in 1963 to 29% in 2006. As referred to earlier in this more in1971comparedto11%2006. census night;thecomparablefigurefor2006was26%.Incontrast,20%ofresidentshadbeenhospitalised25yearsor with alengthofstayfiveyearsormore.In1971,8%in-patientshadbeenhospitalisedforlessthanonemonthon proportion ofin-patientswithashorterlengthstayhasincreasedovertheyears,correspondingdecreaseinthose Length ofstayineachsuccessivecensusispresentedTable 2.7andFigure2.3.Asthistablegraphshow, the 141.5 days,andthosewithorganicmentaldisorders,at140.4days. disability hadthelongestaveragelengthofstay, at165.1days;theywerefollowedbythosewithdevelopmentdisorders, 18%; depressivedisorders,at16%,andorganicmental11%.In-patientswithadiagnosisofintellectual accounted forthelargestproportionofin-patientdays,at33%;thiswasfollowedbyotherandunspecifieddisorders, An analysisofin-patientdays(excludingthoseinhospitalforoneyearormore)ispresentedTable 2.26.Schizophrenia comparable figurefornon-voluntaryin-patientswas10%. voluntary in-patients.Ahigherproportionofin-patients(23%)hadbeenhospitalisedforover10years;the five percentofnon-voluntaryin-patientshadbeenhospitalisedforuptooneyearoncensusnightcompared52% of bothvoluntaryandnon-voluntaryin-patientshospitalisedforuptothreemonthsoncensusnight(Table 2.25).Sixty- Voluntary in-patients’lengthofstaydidnotdiffergreatlyfromthatnon-voluntaryin-patients,withequalproportions for 25yearsormore. with adiagnosisofintellectualdisabilityhadbeenhospitalisedforovertenyears;45%thisgroup depressive disorderandthosewithneurosishadbeeninhospitalforbetweenonethreemonths.Two-thirds ofthose 2006 2001 1991 1981 1971 1963 Under 1 month 1,160 1,473 1,285 25.7 23.0 14.1 10.5 993 872 7.7 months 1 -<3 16.8 13.7 568 593 684 885 985 8.3 6.3 5.9 3 months - <1year 1,124 1,531 11.9 419 716 404 9.7 8.7 8.0 9.2 1,366 2,413 3,219 1 -<5 years 16.2 18.0 16.6 17.3 19.3 548 778 5 -<10 1,717 2,235 years 12.3 13.4 301 368 805 8.9 8.5 9.8 10 -<25 1,574 3,459 4,093 years 10.1 12.5 19.2 24.7 24.6 341 540 and over 25 years 1,902 2,913 3,313 10.5 14.6 23.2 20.8 19.9 355 630 13,984 16,661 100.0 3,389 100.0 4,321 100.0 8,207 100.0 100.0 Total % 1year or more 45.6 53.6 68.8 75.1 77.2 % 5years or more 29.4 35.6 52.2 57.8 57.9 60.6 25
Irish Psychiatric Units and Hospitals Census 2006 26 Irish Psychiatric Units and Hospitals Census 2006 Table Psychiatric 2.9Irish UnitsandHospitals Census 2006. Diagnosisandgender. Children’s centres. emotional disordersofchildhoodandadolescence(Table 2.9). Two childrenwerereturnedineachofthediagnosticcategories depressivedisorders,neurosesandbehavioural 10 Table Psychiatric 2.8Irish UnitsandHospitals Census 2006. Age andgender.20 Children’s centres. children were30 aged 8 years, 13 years and 14 respectively; three were aged 15 and two were aged 16 on censusA total night of (Tableeight children 2.8). (four male and four female) were resident in children’s centres on 31 March 2006. Three40 of these centres wereWarrenstown House,DublinandStAnne’s Children’s CentreinGalway. Two children’s centressubmitreturnstotheNPIRSeachyear,50 andthesewereincludedinthecensusfor2006.Thetwo 60 Children’s centres Figure 2.3 Total Behavioural andemotionaldisorders ofchildhoodandadolescence Eating disorders Neuroses Depressive disorders Schizophrenia, schizotypalanddelusionaldisorders Total 16 years 15 years 14 years 13 years 8 years 0 10.0 20.0 30.0 40.0 50.0 60.0 0.0 Irish PsychiatricIrish UnitsandHospitals Census 1971, 1981, 1991, 2001and006. Length ofstay. Percentages. 13.6 9.2 1971 19.3 57.9 16.9 8.0 1981 Male 17.3 4 0 1 1 1 1 57.8 22.5 8.7 1991 16.6 Female 52.2 4 2 2 0 0 0 Male 36.7 4 2 0 1 0 1 9.7 2001 18.0 Female 1-5 years <3 months 35.6 4 0 1 1 2 0 Total 8 2 3 1 1 1 42.5 5+ years 3-12 month 11.9 Total 200 8 2 1 2 2 1 16.2 6 s 29.4 100.0 100.0 25.0 12.5 25.0 25.0 12.5 25.0 37.5 12.5 12.5 12.5 % % 2 7 Irish Psychiatric Units and Hospitals Census 2006 26 Irish Psychiatric Units and Hospitals Census 2006 5 b) Therewereanadditional60 personswithunspecified/unknowngender. a) Therewereanadditional15personswithunspecified/unknown gender. http://www.isdscotland.org/isd/files/data7.xls Figures forScotlandwereobtainedfromtheISDOnlineScottish HealthStatisticswebsiteat and Inspection,2005). Source: FiguresforEnglandandWales wereobtainedfromCountMeInCensus2005(Commission forHealthCareAudit Table 2.11 than halfofallin-patients. in Scotland.Theproportionofmaleandfemalepatientswassimilarallfourcountries,withmalesaccountingformore The maleandfemalehospitalisationratesinIrelandwerehigherthanthoseWales andEngland,butlowerthanthose 100,000. Wales. Scotlandhadthehighestrate,at162.7per100,000population,andIrelandsecond86.5 rate hasbeenadjustedtothetotalpopulationofIrelandin2002linewithcomparablefiguresforEngland,Scotland and The hospitalisationratesforIreland,England,ScotlandandWales arepresentedinTable 2.11andFigure2.4.TheIrish 5,062,011; thisrepresentsarateof162.7per100,000population. in Wales (Table 2.11).ThecomparablefiguresforScotlandon31March2001were8,236in-patientsapopulationof per 100,000population.Ofthese33,785in-patients,31,668wereresidentinhospitalsEnglandand2,117 33,785 in-patientsinNHSandindependent(privatevoluntary)facilities;thisrepresentedahospitalisationrateof65 In hospitalised patients)was80.0per100,000population.ThePsychiatricCensusofEnglandandWales entitled The Irishpsychiatrichospitalisationrate(basedona2006totalpopulationof4,234,925whom3,389personswere comparisons International Table Psychiatric 2.10Irish UnitsandHospitals Census 2006. Diagnosisandlengthofstay. Children’s centres. hospitalised foraperiodofbetweenoneandtwoweeks(Table 2.10). Three oftheeightchildrenhadbeeninhospitalforbetweenoneandthreemonthsoncensusnight,whiletwo England Scotland Wales Ireland Total 3 months-1year 1 -3months 2 -4weeks 1 -2weeks Under 1week assumption thatthe twosetsofdataarecomparablei.e.that allbedswereoccupiedoncensusnight. but notinothers.Inparticular, researchers in somecountrieshavereturneddatarelatingtobedsbutnotpatients. Thus,wehaveproceededonthe for example,maydifferbetweenjurisdictions. Inaddition,someunitscateringforcertaintypesofspecialistcaremay beincludedinsomenationalreturns While everyefforthasbeenmadetoensure comparabilitybetweeninternationalfigures,designationsastowhatconstitutes privateandvoluntaryprovision, (CommissionforHealthCareAuditandInspection,2005),whichwascarriedoutonthe31March2005,enumerated rates per100,000total population. Psychiatric in-patients inIreland, Wales, Scotland andEnglandby gender. Numbersandpercentages with 17,375 4,176 1,090 1,859 delusional disorders Male schizotypal and Schizophrenia, Numbers 14,233 Female 4,060 1,012 1,530 1 0 1 0 0 0 5 Depressive disorders 31,668 2,117 8,236 3,389 Total 2 0 1 1 0 0 b a Neuroses 171.7 Male 72.6 77.6 95.5 2 0 1 0 1 0 disorders Rates Female Eating 154.4 56.4 67.5 77.6 1 1 0 0 0 0 162.7 Behavioural andemotional disorders of childhood and disorders ofchildhood Total 64.4 72.9 86.5
adolescence Male Percentages 54.9 50.7 51.5 54.9 Count Me 2 0 0 0 1 1 Female Total 44.9 49.3 47.8 45.1 8 1 3 1 2 1 2 7 Irish Psychiatric Units and Hospitals Census 2006 28 Irish Psychiatric Units and Hospitals Census 2006 Sweden thefigurewas49bedsper100,000,whileforNorway itwas106bedsper100,000population(Ruud represents arateof 99.9per100,000population.ThecomparablefigureforDenmark was63.0bedsper100,000;for On 1January2004,therewere60,616beds(including2,146 childandadolescentbeds)inmetropolitanFrance;this 2,182 in-patientsinapopulationof2,903,085;thisrepresents arateof75.2per100,000population. Data producedseparatelyforWales (andgatheredinahospitalcensus whichtookplaceon31March2002)enumerated 100,000 population,ormorethantwicethecomparablerateforIrishinIreland. totalling 427,000),thiswouldindicateahospitalisationrateamongtheIrishlivinginEnglandandWales of179per White Britishcategory(andgiventhatthe2001censusshowedRepublicofIrelandpopulationinEnglandandWales Northern IrelandaswellpersonsfromtheRepublicofIreland.AssumingthatIrishareincludedin group. Thereisnoindicationinthe Of the33,785personsenumeratedin figure forIrelandwas46%.ComparativedatawerenotavailableeitherEnglandor Wales. Fifty-one percentofin-patientsinScotlandhadbeenhospitalforoneyearormoreoncensusnight;thecomparable third (33.3%).ComparativedatawerenotavailableforeitherEnglandorWales. More thanhalf(53%)ofallin-patientsinScotlandwereaged65yearsorover;thecomparablefigureforIrelandwasone In-patients inIreland, Figure 2.4 England, Wales andScotland. Rates per 100,000total population. http://www.isdscotland.org/isd/files/data7.xls Figures forScotlandwereobtainedfromtheISDOnlineScottishHealthStatisticswebsiteat and Inspection,2005). Source: FiguresforEnglandandWales wereobtainedfromCountMeInCensus2005(CommissionforHealthCareAudit
100.0 150.0 200.0 50.0 0.0 100 150 200 50 0 Ireland 86.5 Count MeIn Count MeIn censusdataastowhetherthe‘Irish’groupincludespersonsfrom Wa 72.9 census,767weredescribedasbeinginthe‘WhiteIrish’ethnic le s S cotland 162.7
Englan 64.4 d et al, 2006). 29
Irish Psychiatric Units and Hospitals Census 2006 28 Irish Psychiatric Units and Hospitals Census 2006 Table 2.13 Table 2.1 Unspecified 75 yearsandover 65 -74years 55 -64years 45 -54years 35 -44years 25 -34years 20 -24years Total Unspecified Divorced Widowed Married Single Total 16 -19years Under 16years rates per100,000 population aged 16years andover. PsychiatricIrish UnitsandHospitals Census 2006. status andgender. Marital Numbersandpercentages with 100,000 population aged 16years andover. PsychiatricIrish UnitsandHospitals Census 2006. Age andgender. Numbersandpercentages withrates per 1,373 1,859 1,859 Male Male 166 255 243 296 351 350 280 221 96 17 21 44 1 4 Female Female 1,530 1,530 314 256 261 287 203 132 856 125 179 347 Numbers Numbers 54 20 23
0 3 3,389 3,389 2,229
Total Total 557 552 612 637 483 353 150 291 223 602 37 44 1 7 100.0 100.0 16.4 16.3 18.1 18.8 14.3 10.4 17.8 65.8 0.0 4.4 1.1 0.2 8.6 1.3 6.6 % % 124.7 336.8 253.0 197.9 144.9 100.1 130.0 117.0 205.8 124.7 Male Male 71.6 58.1 13.2 35.0 - - - Rates Rates Female Female 265.5 199.1 149.9 120.1 145.9 121.7 119.9 99.5 71.7 42.7 33.1 16.2 99.5 47.8 - - - 292.5 224.8 174.1 132.6 111.9 125.5 119.3 177.8 111.9 Total Total 85.8 57.2 45.7 14.7 41.4 - - - 29
Irish Psychiatric Units and Hospitals Census 2006 30 Irish Psychiatric Units and Hospitals Census 2006
Table 2.14 Irish Psychiatric Units and Hospitals Census 2006. Marital status and age. Numbers with rates per 100,000 population aged 16 years and over.
Numbers Rates Single Married Widowed Divorced Unspecified Total Single Married Widowed Divorced Unspecified Total Under 16 years 7 0 0 0 0 7 ------16 - 19 years 36 1 0 0 0 37 14.3 161.8 - 0.0 - 14.7 20 - 24 years 133 3 0 0 14 150 41.7 34.5 0.0 0.0 - 45.7 25 - 34 years 312 23 0 2 16 353 82.2 10.3 0.0 60.4 - 57.2 35 - 44 years 336 73 2 12 60 483 282.8 18.4 50.6 103.0 - 85.8 45 - 54 years 390 139 17 11 80 637 605.9 38.6 148.4 95.7 - 132.6 55 - 64 years 373 135 31 11 62 612 853.4 52.3 116.4 176.4 - 174.1 65 - 74 years 344 118 49 4 37 552 864.1 81.3 91.6 218.5 - 224.8 75 years and over 298 110 124 4 21 557 812.0 178.7 137.3 842.1 - 292.5 Unspecified 0 0 0 0 1 1 ------Total 2,229 602 223 44 291 3,389 177.8 41.4 119.3 125.5 - 111.9
31
Irish Psychiatric Units and Hospitals Census 2006 30 Irish Psychiatric Units and Hospitals Census 2006 Table 2.16 Table 2.15 Total Other andunspecified of childhoodandadolescence Behavioural andemotionaldisorders Development disorders Intellectual disability disorders Personality andbehavioural Eating disorders Neuroses Mania Depressive disorders delusional disorders Schizophrenia, schizotypaland Other drugdisorders Alcoholic disorders Organic mentaldisorders Total Unspecified Unskilled Semi-skilled Manual skilled Non-manual Own accountworkers Employers andmanagers Lower professional Higher professional Agricultural workers Farmers Irish PsychiatricIrish UnitsandHospitals Census 2006. Socio-economic group andgender. Numbersand percentages withrates per100,000 population aged 16years andover. rates per100,000 population aged 16years andover. Irish PsychiatricIrish UnitsandHospitals Census 2006. Diagnosisandgender. Numbersandpercentages with 1,859 Male 117 882 269 117 164 122 31 59 23 68 7 1,859 Male 308 167 124 204 736 115 127 28 24 15 Female 2 7 2 1,530 839 132 247 Numbers 89 39 25 88 32 29 3 7 Female 1,530 309 151 288 427 108 Numbers 84 42 16 34 11 49 5 6 3,389 1,721 Total 401 206 203 369 147 146 10 56 55 75 3,389 1,163 Total 617 251 275 492 164 235 13 70 18 58 26 7 100.0 50.8 11.8 10.9 6.1 6.0 0.3 1.7 4.3 1.6 2.2 4.3 % 100.0 18.2 14.5 34.3 0.2 0.4 7.4 2.1 0.5 1.7 8.1 0.8 4.8 6.9 % 124.7 407.6 284.2 362.7 102.1 Male 85.8 69.4 76.4 13.5 54.0 25.9 8.2 124.7 Male 20.7 11.2 13.7 49.4 0.1 0.5 1.9 0.1 1.6 8.3 1.0 7.7 8.5 Rates Female Rates Female 258.5 200.6 99.5 77.5 46.3 65.9 12.8 45.9 48.6 72.9 46.9 6.0 99.5 20.1 18.7 27.8 0.3 0.4 5.5 2.7 1.0 2.2 9.8 0.7 3.2 7.0 111.9 111.9 318.2 249.9 264.6 Total Total 20.4 16.2 38.4 82.0 63.3 69.1 13.2 48.8 35.5 82.7 0.2 0.4 8.3 2.3 0.6 1.9 9.1 0.9 5.4 7.8 7.4 31
Irish Psychiatric Units and Hospitals Census 2006 32 Irish Psychiatric Units and Hospitals Census 2006
Table 2.17 Irish Psychiatric Units and Hospitals Census 2006. Diagnosis and age. Numbers with rates per 100,000 population aged 16 years and over.
Numbers Under 16 16 - 19 20 - 24 25 – 34 35 - 44 45 - 54 55 - 64 65 - 74 75 yrs and years years yrs years years years years years over Unspecified Total Organic mental disorders 0 0 0 1 1 5 21 56 151 0 235 Alcoholic disorders 0 1 3 20 27 44 30 21 18 0 164 Other drug disorders 0 0 6 9 3 1 4 1 2 0 26 Schizophrenia, schizotypal and delusional disorders 0 11 57 126 145 220 225 217 161 1 1,163 Depressive disorders 4 8 19 45 67 83 97 97 72 0 492 Mania 0 2 10 25 43 60 66 42 27 0 275 Neuroses 0 1 0 4 13 11 7 6 16 0 58 Eating disorders 2 3 5 4 2 1 0 0 1 0 18 Personality and behavioural disorders 1 1 2 7 22 15 14 2 6 0 70 Intellectual disability 0 1 1 13 51 61 51 37 36 0 251 Development disorders 0 1 0 1 5 2 0 0 4 0 13 Behavioural and emotional disorders of childhood and adolescence 0 1 1 0 1 3 1 0 0 0 7 Other and unspecified 0 7 46 98 103 131 96 73 63 0 617 Total 7 37 150 353 483 637 612 552 557 1 3,389 Rates Organic mental disorders - 0.0 0.0 0.2 0.2 1.0 6.0 22.8 79.3 - 7.8 Alcoholic disorders - 0.4 0.9 3.2 4.8 9.2 8.5 8.6 9.5 - 5.4 Other drug disorders - 0.0 1.8 1.5 0.5 0.2 1.1 0.4 1.1 - 0.9 Schizophrenia, schizotypal and delusional disorders - 4.4 17.4 20.4 25.8 45.8 64.0 88.4 84.6 - 38.4 Depressive disorders - 3.2 5.8 7.3 11.9 17.3 27.6 39.5 37.8 - 16.2 Mania - 0.8 3.0 4.0 7.6 12.5 18.8 17.1 14.2 - 9.1 Neuroses - 0.4 0.0 0.6 2.3 2.3 2.0 2.4 8.4 - 1.9 Eating disorders - 1.2 1.5 0.6 0.4 0.2 0.0 0.0 0.5 - 0.6 Personality and behavioural disorders - 0.4 0.6 1.1 3.9 3.1 4.0 0.8 3.2 - 2.3 Intellectual disability - 0.4 0.3 2.1 9.1 12.7 14.5 15.1 18.9 - 8.3 Development disorders - 0.4 0.0 0.2 0.9 0.4 0.0 0.0 2.1 - 0.4 Behavioural and emotional disorders of childhood and adolescence - 0.4 0.3 0.0 0.2 0.6 0.3 0.0 0.0 - 0.2 Other and unspecified - 2.8 14.0 15.9 18.3 27.3 27.3 29.7 33.1 - 20.4 Total - 14.7 45.7 57.2 85.8 132.6 174.1 224.8 292.5 - 111.9 33
Irish Psychiatric Units and Hospitals Census 2006 32 Irish Psychiatric Units and Hospitals Census 2006
Table 2.18 Irish Psychiatric Units and Hospitals Census 2006. Diagnosis and socio-economic group. Numbers with rates per 100,000 population aged 16 years and over.
Numbers Own Agricultural Higher Lower Employers and account Non- Manual Semi- Farmers workers professional professional managers workers manual Skilled skilled Unskilled Unspecified Total Organic mental disorders 16 3 7 23 14 2 29 18 14 11 98 235 Alcoholic disorders 8 2 2 11 4 1 18 20 19 20 59 164 Other drug disorders 0 1 0 0 1 0 2 2 3 4 13 26 Schizophrenia, schizotypal and delusional disorders 49 39 13 38 7 4 133 72 80 210 518 1,163 Depressive disorders 25 7 13 25 11 1 63 37 34 48 228 492 Mania 17 4 9 20 8 1 48 20 22 34 92 275 Neuroses 6 2 2 3 1 1 8 3 1 8 23 58 Eating disorders 1 0 1 1 1 0 5 1 0 1 7 18 Personality and behavioural disorders 1 5 1 3 0 0 16 3 5 9 27 70 Intellectual disability 7 7 0 0 0 0 12 1 9 30 185 251 Development disorders 0 0 0 1 0 0 1 0 0 1 10 13 Behavioural and emotional disorders of childhood and adolescence 0 0 0 0 0 0 1 0 1 0 5 7 Other and unspecified 16 5 7 22 9 0 33 26 18 25 456 617 Total 146 75 55 147 56 10 369 203 206 401 1,721 3,389 Rates Organic mental disorders 9.1 10.6 4.5 7.6 3.3 1.5 5.4 5.6 5.6 6.9 18.1 7.8 Alcoholic disorders 4.5 7.1 1.3 3.7 0.9 0.7 3.4 6.2 7.6 12.5 10.9 5.4 Other drug disorders 0.0 3.5 0.0 0.0 0.2 0.0 0.4 0.6 1.2 2.5 2.4 0.9 Schizophrenia, schizotypal and delusional disorders 27.8 137.6 8.4 12.6 1.6 2.9 24.9 22.5 31.8 130.9 95.8 38.4 Depressive disorders 14.2 24.7 8.4 8.3 2.6 0.7 11.8 11.5 13.5 29.9 42.2 16.2 Mania 9.6 14.1 5.8 6.6 1.9 0.7 9.0 6.2 8.8 21.2 17.0 9.1 Neuroses 3.4 7.1 1.3 1.0 0.2 0.7 1.5 0.9 0.4 5.0 4.3 1.9 Eating disorders 0.6 0.0 0.6 0.3 0.2 0.0 0.9 0.3 0.0 0.6 1.3 0.6 Personality and behavioural disorders 0.6 17.6 0.6 1.0 0.0 0.0 3.0 0.9 2.0 5.6 5.0 2.3 Intellectual disability 4.0 24.7 0.0 0.0 0.0 0.0 2.2 0.3 3.6 18.7 34.2 8.3 Development disorders 0.0 0.0 0.0 0.3 0.0 0.0 0.2 0.0 0.0 0.6 1.8 0.4 Behavioural and emotional disorders of childhood and adolescence 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.0 0.4 0.0 0.9 0.2 Other and unspecified 9.1 17.6 4.5 7.3 2.1 0.0 6.2 8.1 7.2 15.6 84.3 20.4 Total 82.7 264.6 35.5 48.8 13.2 7.4 69.1 63.3 82.0 249.9 318.2 111.9 33
Irish Psychiatric Units and Hospitals Census 2006 34 Irish Psychiatric Units and Hospitals Census 2006 Table 2.0 Table 2.19
Total Other andunspecified childhood andadolescence Behavioural andemotionaldisordersof Development disorders Intellectual disability Personality andbehaviouraldisorders Eating disorders Neuroses Mania depressive disorders delusional disorders Schizophrenia, schizotypaland Other drugdisorders Alcoholic disorders Total % Organic mentaldisorders Non-voluntary % Voluntary percentages withrates per100,000 population aged 16years andover. Irish PsychiatricIrish UnitsandHospitals Census 2006. Legal status oncensus andgender. night Numbers and Irish PsychiatricIrish UnitsandHospitals Census 2006. Legal status oncensus anddiagnosis. night Numbersand percentages withrates per100,000 population aged 16years andover. 1,859 1,419 Male 23.7 76.3 Voluntary 440 2,645 475 232 203 431 866 126 160 55 15 52 17 Numbers 6 7 voluntary Female 1,530 1,226 19.9 80.1 304 Non- 744 142 297 19 15 72 61 38 75 1 6 3 6 9 Numbers 3,389 1,163 Total 3,389 2,645 617 251 275 492 164 235 Total 22.0 78.0 13 70 18 58 26 744 7 voluntary % 100.0 Non- 19.1 39.9 10.1 0.1 0.8 2.6 2.0 0.4 0.8 9.7 8.2 1.2 5.1 124.7 Male 29.5 95.2 Voluntary 87.3 15.7 14.2 28.6 0.2 0.2 7.7 1.8 0.5 1.7 6.7 0.6 4.2 5.3 Rates Female voluntary 99.5 19.8 79.7 Rates Non- 24.6 4.7 0.0 0.2 0.6 0.5 0.1 0.2 0.3 2.4 2.0 9.8 1.3 2.5 111.9 111.9 Total Total 20.4 16.2 38.4 24.6 87.3 0.2 0.4 8.3 2.3 0.6 1.9 9.1 0.9 5.4 7.8 35
Irish Psychiatric Units and Hospitals Census 2006 34 Irish Psychiatric Units and Hospitals Census 2006 Table 2.1 Table Psychiatric 2.22Irish UnitsandHospitals Census 2006. Length ofstay andgender. Numberswithpercentages. Total Re-admission First ever Under 1week 1-< 2weeks 1-< 3months 2-< 4weeks 10-< 25years 5-< 10years 1-< 5years 3 months-<1year Total 25 yearsandover Irish PsychiatricIrish UnitsandHospitals Census 2006. Legal oncensus by category night order ofadmission. Numbers withrates per100,000 population aged 16years andover. Voluntary 1,768 2,645 877 Non-voluntary 1,859 Male 124 171 148 175 313 219 271 225 213 Numbers 513 231 744 Numbers Female 1,530 111 159 159 126 235 185 297 128 130 2,281 1,108 3,389 Total 3,389 Total 20.8 22.5 330 307 235 568 341 301 548 404 355 % Voluntary 100.0 Male 29.0 87.3 58.4 14.6 11.5 16.8 11.8 12.1 9.2 8.0 6.7 9.4 Percentages Non-voluntary Rates Female 100.0 10.4 19.4 10.4 15.4 12.1 7.3 8.2 8.4 8.5 16.9 24.6 7.6 111.9 100.0 Total Total 36.6 75.3 16.2 11.9 16.8 10.5 10.1
6.9 9.7 9.1 8.9 35
Irish Psychiatric Units and Hospitals Census 2006 36 Irish Psychiatric Units and Hospitals Census 2006
Table 2.23 Irish Psychiatric Units and Hospitals Census 2006. Length of stay and age. Numbers with percentages.
Numbers Under 16 yrs 16 - 19 yrs 20 - 24 yrs 25 - 34 yrs 35 - 44 yrs 45 - 54 yrs 55 - 64 yrs 65 - 74 yrs 75 yrs & Over Unspecified Total Under 1 week 0 9 23 62 77 70 48 31 10 0 330 1-< 2 weeks 1 4 21 39 42 56 40 19 13 0 235 2-< 4 weeks 2 5 28 51 54 52 50 41 24 0 307 1-< 3 months 2 10 50 97 103 107 80 61 58 0 568 3 months-< 1 year 1 7 11 50 50 80 73 66 66 0 404 1-< 5 years 1 2 15 27 68 75 111 115 134 0 548 5-< 10 years 0 0 2 19 34 56 59 56 74 1 301 10-< 25 years 0 0 0 8 37 89 74 71 62 0 341 25 years and over 0 0 0 0 18 52 77 92 116 0 355 Total 7 37 150 353 483 637 612 552 557 1 3,389
Percentages Under 1 week 0.0 24.3 15.3 17.6 15.9 11.0 7.8 5.6 1.8 0.0 9.7 1-< 2 weeks 14.3 10.8 14.0 11.0 8.7 8.8 6.5 3.4 2.3 0.0 6.9 2-< 4 weeks 28.6 13.5 18.7 14.4 11.2 8.2 8.2 7.4 4.3 0.0 9.1 1-< 3 months 28.6 27.0 33.3 27.5 21.3 16.8 13.1 11.1 10.4 0.0 16.8 3 months-< 1 year 14.3 18.9 7.3 14.2 10.4 12.6 11.9 12.0 11.8 0.0 11.9 1-< 5 years 14.3 5.4 10.0 7.6 14.1 11.8 18.1 20.8 24.1 0.0 16.2 5-< 10 years 0.0 0.0 1.3 5.4 7.0 8.8 9.6 10.1 13.3 100.0 8.9 10-< 25 years 0.0 0.0 0.0 2.3 7.7 14.0 12.1 12.9 11.1 0.0 10.1 25 years and over 0.0 0.0 0.0 0.0 3.7 8.2 12.6 16.7 20.8 0.0 10.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 3 7
Irish Psychiatric Units and Hospitals Census 2006 36 Irish Psychiatric Units and Hospitals Census 2006
Table 2.24 Irish Psychiatric Units and Hospitals Census 2006. Length of stay and diagnosis. Numbers with percentages.
Numbers Under 1-< 2 2-< 4 1-< 3 3 months- 5-< 10 10-< 25 25 years 1 week weeks weeks months < 1 year 1-< 5 years years years and over Total Organic mental disorders 4 3 4 29 55 93 29 13 5 235 Alcoholic disorders 34 19 18 28 8 29 19 8 1 164 Other drug disorders 6 3 2 5 2 3 1 1 3 26 Schizophrenia, schizotypal and delusional disorders 49 44 61 167 144 207 142 174 175 1,163 Depressive disorders 80 48 64 107 58 73 37 18 7 492 Mania 44 25 38 51 43 32 8 20 14 275 Neuroses 5 9 4 12 5 4 3 8 8 58 Eating disorders 2 1 5 6 4 0 0 0 0 18 Personality and behavioural disorders 6 2 2 6 12 13 10 14 5 70 Intellectual disability 1 1 1 7 13 33 28 54 113 251 Development disorders 0 1 0 0 1 4 0 1 6 13 Behavioural and emotional disorders of childhood and adolescence 1 1 0 1 0 0 3 0 1 7 Other and unspecified 98 78 108 149 59 57 21 30 17 617 Total 330 235 307 568 404 548 301 341 355 3,389
Percentages Organic mental disorders 1.7 1.3 1.7 12.3 23.4 39.6 12.3 5.5 2.1 100.0 Alcoholic disorders 20.7 11.6 11.0 17.1 4.9 17.7 11.6 4.9 0.6 100.0 Other drug disorders 23.1 11.5 7.7 19.2 7.7 11.5 3.8 3.8 11.5 100.0 Schizophrenia, schizotypal and delusional disorders 4.2 3.8 5.2 14.4 12.4 17.8 12.2 15.0 15.0 100.0 Depressive disorders 16.3 9.8 13.0 21.7 11.8 14.8 7.5 3.7 1.4 100.0 Mania 16.0 9.1 13.8 18.5 15.6 11.6 2.9 7.3 5.1 100.0 Neuroses 8.6 15.5 6.9 20.7 8.6 6.9 5.2 13.8 13.8 100.0 Eating disorders 11.1 5.6 27.8 33.3 22.2 0.0 0.0 0.0 0.0 100.0 Personality and behavioural disorders 8.6 2.9 2.9 8.6 17.1 18.6 14.3 20.0 7.1 100.0 Intellectual disability 0.4 0.4 0.4 2.8 5.2 13.1 11.2 21.5 45.0 100.0 Development disorders 0.0 7.7 0.0 0.0 7.7 30.8 0.0 7.7 46.2 100.0 Behavioural and emotional disorders of childhood and adolescence 14.3 14.3 0.0 14.3 0.0 0.0 42.9 0.0 14.3 100.0 Other and unspecified 15.9 12.6 17.5 24.1 9.6 9.2 3.4 4.9 2.8 100.0 Total 9.7 6.9 9.1 16.8 11.9 16.2 8.9 10.1 10.5 100.0 3 7
Irish Psychiatric Units and Hospitals Census 2006 38 Irish Psychiatric Units and Hospitals Census 2006 Table 2.6 Table 2.5 thus excluded. a Patientswithlengthofstayoneyearormorewereexcluded fromthisanalysis.Forty-sixpercentofpatientswere
1-< 2weeks Under 1week 3 months-<1year 2-< 4weeks Total Other andunspecified childhood andadolescence Behavioural andemotionaldisordersof Development disorders Intellectual disability Personality andbehaviouraldisorders Eating disorders Neuroses Mania 1-< 5years 1-< 3months Depressive disorders disorders Schizophrenia, schizotypalanddelusional Other drugdisorders Alcoholic disorders 10-< 25years 5-< 10years Organic mentaldisorders Total 25 yearsandover Irish PsychiatricIrish UnitsandHospitals Census 2006. Length ofstay andlegal status oncensus night. Numbers with percentages. Irish PsychiatricIrish UnitsandHospitals Census 2006. Analysis ofin-patient days by diagnosis(excluding patients inhospital for oneyear ormore) Voluntary 2,645 287 239 181 415 238 417 248 321 299 in-patient days Number of a Involuntary Numbers . Numberswithpercentages. 117,596 20,852 11,750 18,993 13,334 38,620 3,797 2,765 1,169 1,494 3,757 283 743
39 166 151 133 744 43 68 54 53 34 42 in-patient days % of 3,389 Total 235 330 404 568 307 548 341 301 355
100.0 17.7 10.0 16.2 32.8 11.3 0.0 0.2 3.2 2.4 1.0 1.3 0.6 3.2 Voluntary Average number 100.0 10.9 15.8 15.7 11.3 12.1 of days 6.8 9.0 9.0 9.4 Percentages 141.5 165.1 140.4 Involuntary 63.8 42.4 13.0 98.8 64.9 42.7 58.5 53.2 83.1 41.3 35.1 100.0 17.9 22.3 20.3 5.8 9.1 7.3 7.1 4.6 5.6 Median number of days 100.0 Total 16.8 11.9 16.2 10.5 10.1 142 116 122 9.7 9.1 6.9 8.9 30 22 46 38 25 23 23 46 12 14 9
39
Irish Psychiatric Units and Hospitals Census 2006 38 Irish Psychiatric Units and Hospitals Census 2006 Figure 3.1 Table 3.1).TheHSEWest areahadthelowestrateofhospitalisation,at96.4per100,000population. followed bytheHSEDublinNorth-Eastarea,at113.0,andMid-Leinster105.7(Figure3.1 The HSESouthareahadthehighestrateofhospitalisationoncensusnight,at131.0per100,000population;itwas treated. Thetablesreferredtointhetextmaybefoundatendofthischapter. a personwasadmittedtohospital,ratherthanthegeographicalareaorlocationofhospitalwherethat Allocation toaparticularHealthServiceExecutive(HSE)administrativeareawasdeterminedbytheaddressfromwhich 3. Executive Health Service (HSE)administrative areas HSE West HSE South Galway, Clare, Limerick, and North Tipperary. Includes counties Donegal, Sligo, Leitrim, Roscommon, Mayo, Population aged 16 years and over: 724,079 Kilkenny, Wexford, Waterford and South Tipperary. Cork, North Lee, South Lee and West Cork), Kerry, Carlow, Includes counties Cork (including Local Health Offices North Population aged 16 years and over: 773,556. Rates per100,000 population aged 16years andover. Irish PsychiatricIrish UnitsandHospitals Census 2006. Hospitalisation rates by HSEadministrative areas. HSE Sout 131. HSE West . 9 0 6.4 h N H North-Eas orthern Ireland Mid-Leinste SE Dubli HSE Dublin 113.0 105. South West and Dublin West and Dún Laoghaire). Offices Dublin South City, Dublin South East, Dublin Westmeath, and South Dublin (including Local Health Includes counties Wicklow, Kildare, Laois, Offaly, Longford, Population aged 16 years and over: 887,282. HSE Dublin Mid-Leinster HSE Dublin North-East Dublin, Dublin North Central and Dublin North). North Dublin (including Local Health Offices North West Includes counties Louth, Meath, Cavan, Monaghan, and Population aged 16 years and over: 643,976 7 n t r .
39
Irish Psychiatric Units and Hospitals Census 2006 40 Irish Psychiatric Units and Hospitals Census 2006 North-East, at24.7,andHSEDublinMid-Leinster, at20.2. non-voluntary hospitalisationwashighestinHSESouth,at 35.7 per100,000population;thiswasfollowedbyHSEDublin East was22%,whilebothHSEDublinMid-LeinsterandtheWest wereeachrecordedat19%(Table 3.6). Therateof HSE Southhadthehighestproportionofnon-voluntarypatients,at27%;comparablefigureforDublinNorth- Legal status Mid-Leinster. second highestinallotherareas;ratesforthisgrouprangedfrom27.8per100,000HSESouthto19.0Dublin disorders hadthesecondhighestrateofhospitalisationinHSEWest, at13.8;theotherandunspecifiedgroup hadthe 43.0 inHSESouthto33.1per100,000populationDublinMid-Leinster(Figure3.2andTable 3.5).Depressive Schizophrenia hadhighestratesacrossallHSEareas,withlittlevariationintheseareas.Ratesrangedfrom Diagnosis without paidemployees)andemployersmanagershadthelowesthospitalisationratesacrossallHSEareas. East, at199.0,andHSESouth,384.5per100,000population(Table 3.4).Ownaccountworkers(self-employed rate ofhospitalisation,at202.2and261.1respectively;agriculturalworkershadthehighestinHSEDublinNorth- economic groupinallHSEareas.IntheDublinMid-LeinsterandWest areastheunskilledgroup hadthehighest Hospitalisation ratesforbothunskilledworkersandagriculturalwerethehighestfoundinanysocio- Socio-economic group overall wasquitesmall. persons hadthesecondhighestrateinHSEWest (112.2)andHSESouth(198.9),althoughthenumbersofdivorcedpersons had thesecondhighestrateofhospitalisationinHSEDublinNorth-East(139.7)andMid-Leinster(139.9);divorced per 100,000populationinHSESouthto146.5DublinMid-Leinster(Table 3.3).Widowed persons Single personshadthehighestrateofhospitalisationforallmaritalstatusgroupsinHSEareas;ratesrangedfrom225.9 status Marital patients residentinHSESouthwereaged75yearsandoveroncensusnight. 40%; itwasfollowedbyHSEDublinNorth-East,at32%,andMid-Leinster, at30%(Table 3.2).One-fifthof The HSESouthareahadthehighestproportionofelderlypatients(i.e.thoseaged65yearsandover)oncensusnight,at had thesecondhighestrateinallareas;theyrangedfrom310.3per100,000HSESouthto162.7West. ranged from386.5per100,000inHSESouthto159.6West (Table 3.2).The65–74-yearsagegroup In allareaswiththeexceptionofHSEWest, hospitalisationrateswerehighestforthe75-yearsandoveragegroup;they to 109.6per100,000intheHSEWest area(Table 3.1). Males hadahigherhospitalisationratethanfemalesinallHSEareas;theseratesrangedfrom145.7theSoutharea Gender andage 41
Irish Psychiatric Units and Hospitals Census 2006 40 Irish Psychiatric Units and Hospitals Census 2006 length ofstayon censusnight,at68days(Table 3.8). HSE DublinMid-Leinsteraccounted forthelargestproportionofin-patientdays,at34%; italsohadthelongestaverage years ormoreoncensusnight. for thoseresidentinHSESouth was53%.SixteenpercentofpatientsresidentinHSEWest hadbeeninhospitalfor25 Dublin Mid-Leinsterwerelong-stay(i.e.hadbeeninhospital foroneyearormoreoncensusnight);thecomparablefigure census night;thecomparablefigureforHSESouthwas36% (Table 3.7).Incontrast,37%ofpatientsresidentinHSE Almost half(48%)ofpatientsresidentinHSEDublinMid-Leinster hadbeeninhospitalforlessthanthreemonthson Length ofstay Figure 3 .2 HSE West HSE South Galway, Clare, Limerick, and North Tipperary. Includes counties Donegal, Sligo, Leitrim, Roscommon, Mayo, Population aged 16 years and over: 724,079 Kilkenny, Wexford, Waterford and South Tipperary. Cork, North Lee, South Lee and West Cork), Kerry, Carlow, Includes counties Cork (including Local Health Offices North Population aged 16 years and over: 773,556. administrative areas. Rates per100,000 population aged 16years andover. Irish PsychiatricIrish UnitsandHospitals Census 2006. Hospitalisation rates for schizophrenia by HSE HSE Sout 4 3.0 HSE West . 4 0.6 h N H North-Eas orthern Ireland Mid-Leinste SE Dubli HSE Dublin 37.0 33.1 South West and Dublin West and Dún Laoghaire). Offices Dublin South City, Dublin South East, Dublin Westmeath, and South Dublin (including Local Health Includes counties Wicklow, Kildare, Laois, Offaly, Longford, Population aged 16 years and over: 887,282. HSE Dublin Mid-Leinster HSE Dublin North-East Dublin, Dublin North Central and Dublin North). North Dublin (including Local Health Offices North West Includes counties Louth, Meath, Cavan, Monaghan, and Population aged 16 years and over: 643,976 n t r .
41
Irish Psychiatric Units and Hospitals Census 2006 42 Irish Psychiatric Units and Hospitals Census 2006 Numbers withrates per100,000 population aged 16years andover. Table Psychiatric 3.2Irish UnitsandHospitals Census 2006. Executive Health Service administrative areas by age. Table 3.1 Non-national HSE West North-East HSE Dublin Mid-Leinster HSE Dublin Total HSE South HSE West HSE South HSE DublinNorth-East HSE DublinMid-Leinster Total Non-national North-East HSE Dublin Mid-Leinster HSE Dublin HSE South Total Non-national HSE West Irish PsychiatricIrish UnitsandHospitals Census 2006. Executive Health Service administrative areas by gender. Numbers withrates per100,000 population aged 16years andover. Under 16 3 1 3 0 7 0 ------16-19 17.9 15.5 14.7 14.3 9.6 13 10 37 5 0 9 - 24 20- 55.7 48.3 29.0 42.7 45.7 150 58 33 36 21 2 - 1,859 Male 396 559 396 500 25- 56.5 56.8 59.9 57.2 54.7 8 111 353 81 88 72 34 1 - Numbers 35-44 80.6 94.4 72.3 95.6 85.8 Female 134 139 113 483 1,530 95 2 302 454 332 438 - 4 156.0 131.4 122.6 132.6 124.7 45-54 Numbers 151 182 154 149 637 Rates 1 - 3,389 1,013 163.3 188.8 152.0 174.1 183.7 55-64 Total 157 698 179 110 728 938 162 612 12 4 - 213.6 203.7 310.3 224.8 162.7 65-74 105 132 210 104 552 1 - 109.6 124.7 145.7 125.7 116.1 Male 75 &over - 298.0 386.5 347.4 292.5 159.6 147 199 124 557 86 1 - Rates Female Unspecified 116.5 100.9 83.3 99.5 95.9 - 1 0 0 0 1 0 ------111.9 131.0 113.0 1,013 105.7 105.7 3,389 131.0 113.0 111.9 Total Total 96.4 96.4 938 728 698 12 - - 43
Irish Psychiatric Units and Hospitals Census 2006 42 Irish Psychiatric Units and Hospitals Census 2006
Table 3.3 Irish Psychiatric Units and Hospitals Census 2006. Health Service Executive administrative areas by marital status. Numbers with rates per 100,000 population aged 16 years and over.
Numbers Rates Single Married Widowed Divorced Unspecified Total Single Married Widowed Divorced Unspecified Total HSE Dublin Mid-Leinster 565 184 69 10 110 938 146.5 44.9 139.9 92.8 - 105.7 HSE Dublin North-East 473 132 51 7 65 728 171.4 43.7 139.7 97.1 - 113.0 HSE South 686 168 82 18 59 1,013 225.9 43.6 161.2 198.9 - 131.0 HSE West 500 113 21 9 55 698 173.3 31.6 41.9 112.2 - 96.4 Non-national 5 5 0 0 2 12 ------Total 2,229 602 223 44 291 3,389 177.8 41.4 119.3 125.5 - 111.9
Table 3.4 Irish Psychiatric Units and Hospitals Census 2006. Health Service Executive administrative areas by socio-economic group. Numbers with rates per 100,000 population aged 16 years and over.
Numbers Own Agricultural Higher Lower Employers account Non- Manual Semi- Farmers workers professional professional and managers workers manual skilled skilled Unskilled Unspecified Total HSE Dublin Mid-Leinster 25 7 25 54 16 4 137 58 57 83 472 938 HSE Dublin North-East 8 9 11 27 14 4 70 39 40 63 443 728 HSE South 55 41 14 29 16 1 96 64 71 146 480 1,013 HSE West 58 18 5 37 8 1 65 42 38 109 317 698 Non-national 0 0 0 0 2 0 1 0 0 0 9 12 Total 146 75 55 147 56 10 369 203 206 401 1,721 3,389 Rates HSE Dublin Mid-Leinster 109.4 130.2 41.4 57.3 10.8 10.8 82.1 67.4 88.4 202.2 293.4 105.7 HSE Dublin North-East 37.9 199.0 35.5 42.1 14.5 14.2 55.3 54.5 76.0 193.7 384.0 113.0 HSE South 86.5 384.5 41.3 40.3 16.6 2.7 76.0 72.8 101.2 323.6 367.3 131.0 HSE West 84.1 231.1 16.9 52.3 9.5 3.0 56.7 56.0 59.4 261.1 236.6 96.4 Non-national ------Total 82.7 264.6 35.5 48.8 13.2 7.4 69.1 63.3 82.0 249.9 318.2 111.9 43
Irish Psychiatric Units and Hospitals Census 2006 44 Irish Psychiatric Units and Hospitals Census 2006
Table 3.5 Irish Psychiatric Units and Hospitals Census 2006. Health Service Executive administrative areas by diagnosis. Numbers with rates per 100,000 population aged 16 years and over.
Numbers Behavioural Schizophrenia, Personality and emotional Organic Other schizotypal and disorders of Other mental Alcoholic drug and delusional Depressive Eating behavioural Intellectual Development childhood and and disorders disorders disorders disorders disorders Mania Neuroses disorders disorders disability disorders adolescence Unspecified Total HSE Dublin Mid-Leinster 94 35 3 294 138 76 15 8 24 75 3 4 169 938 HSE Dublin North-East 62 37 6 238 89 54 9 5 9 59 4 1 155 728 HSE South 60 50 11 333 163 74 13 4 24 60 5 1 215 1,013 HSE West 18 41 6 294 100 71 21 1 13 57 1 1 74 698 Non-national 1 1 0 4 2 0 0 0 0 0 0 0 4 12 Total 235 164 26 1,163 492 275 58 18 70 251 13 7 617 3,389
Rates HSE Dublin Mid-Leinster 10.6 3.9 0.3 33.1 15.6 8.6 1.7 0.9 2.7 8.5 0.3 0.5 19.0 105.7 HSE Dublin North-East 9.6 5.7 0.9 37.0 13.8 8.4 1.4 0.8 1.4 9.2 0.6 0.2 24.1 113.0 HSE South 7.8 6.5 1.4 43.0 21.1 9.6 1.7 0.5 3.1 7.8 0.6 0.1 27.8 131.0 HSE West 2.5 5.7 0.8 40.6 13.8 9.8 2.9 0.1 1.8 7.9 0.1 0.1 10.2 96.4 Non-national ------Total 7.8 5.4 0.9 38.4 16.2 9.1 1.9 0.6 2.3 8.3 0.4 0.2 20.4 111.9 45
Irish Psychiatric Units and Hospitals Census 2006 44 Irish Psychiatric Units and Hospitals Census 2006 Table 3.8 a Table 3.7 Table 3.6 Total Non-national HSE West HSE South HSE DublinNorth-East HSE DublinMid-Leinster Total Non-national HSE West HSE South North-East HSE Dublin Mid-Leinster HSE Dublin Total Non-national HSE West HSE South North-East HSE Dublin Mid-Leinster HSE Dublin Total Non-national HSE West HSE South HSE DublinNorth-East HSE DublinMid-Leinster thus excluded. Patients withalengthofstay oneyearormorewereexcludedfromthisanalysis.Forty-six percentofpatientswere Irish PsychiatricIrish UnitsandHospitals Census 2006. Executive Health Service administrative areas by lengthof stay. Numberswithrates per100,000 population aged 16years andover. Analysis ofin-patient days. Irish PsychiatricIrish UnitsandHospitals Census 2006. Executive Health Service administrative areas. Legal status oncensus night. Numberswithrates per100,000 population aged 16years andover. Irish PsychiatricIrish UnitsandHospitals Census 2006. Executive Health Service administrative areas.
Under 1 week 25.0 11.9 12.4 330 116 9.7 5.9 9.3 83 60 68 3 Voluntary weeks 1-< 2 1-< 235 6.9 0.0 6.4 7.7 6.6 6.8 2,645 45 78 48 64 0 569 737 569 759 11 a Number 117,596 weeks Numberswithpercentages. 20,938 30,644 25,478 40,409 In-patient days 2 10.0 307 -< 4 Non-voluntary 9.1 8.3 8.2 8.7 9.4 Numbers 57 88 73 88 127 1 months 16.8 16.7 16.5 13.7 17.6 19.6 1-< 3 1-< 128 184 568 115 139 744 129 276 159 179 2 1 3 months 100.0 -< 1year 3,389 1,013 17.8 26.1 21.7 34.4 Total 0.1 698 728 938 % 12 11.9 11.0 12.0 15.0 141 404 111 Percentages 0.0 9.3 87 65 Numbers 0
% Non-voluntary
Average numberofdays years 16.2 25.0 13.9 17.8 17.9 14.7 1-< 5 1-< 130 138 548 180 97 3
22.0 18.5 27.2 21.8 19.1 8.3 5-< 10 years 25.0 11.3 301 114 8.9 7.7 8.1 7.6 59 71 54 Voluntary 3 63.8 21.2 57.4 64.4 63.1 68.1 Rates 87.3 78.6 95.3 88.4 85.5 10-< 25 10-< years 10.1 10.0 14.1 341 143 - 0.0 8.2 7.2 60 68 70 0 Median numberofdays Non-voluntary and over 25 years 10.5 16.0 10.3 355 112 100 0.0 9.9 7.2 24.6 17.8 35.7 24.7 20.2 75 68
0 - 100.0 100.0 100.0 100.0 100.0 100.0 3,389 1,013 111.9 131.0 113.0 105.7 Total Total 96.4 698 728 938 30 14 26 30 30 32 12 - 45
Irish Psychiatric Units and Hospitals Census 2006 46 Irish Psychiatric Units and Hospitals Census 2006 47
Irish Psychiatric Units and Hospitals Census 2006 46 Irish Psychiatric Units and Hospitals Census 2006 b a workers and66%offarmersresident oncensusnightwereinpsychiatrichospitals. in generalhospitalpsychiatric units and2%wereinprivatehospitals(Table 4.5).Ninety-one percentofagricultural Seventy-two percentoftheunskilledoccupationalgroupresident oncensusnightwereinpsychiatrichospitals,23% Socio-economic group resident inprivatehospitalsweremarried. hospital psychiatricunitsand41%ofpatientsinprivatehospitals (Table 4.4).Morethanone-third(38%)ofpatients Single patientsaccountedfor74%ofresidentinpsychiatric hospitalsoncensusnight,63%ofpatientsingeneral status Marital census night. Chapter 2)thusbringingto30thetotalnumberofpersonsagedunder18yearswhowereresidentinunitsandhospitals on hospitals andeleveninprivate(Table 4.3).Anadditionaleightpatientswereresidentinchildren’s centres (see of agewereresidentinunitsandhospitalsoncensusnight,eightgeneralhospitalpsychiatricunits,three resident inpsychiatrichospitalsandprivatewereaged75yearsorover. Atotalof22personsunder18years proportion forprivatehospitalswas36%,with16%generalhospitalpsychiatricunits(Table 4.2).One-fifthofpatients Psychiatric hospitalshadthelargestproportion(42%)ofpatientsaged65yearsoroveroncensusnight.Thecomparable psychiatric hospitals;femalesaccountedfor59%ofresidentsinprivatehospitals(Table 4.1). Males accountedformorethanhalf(52%)ofallresidentsingeneralhospitalpsychiatricunitsand58% Gender andage Table Psychiatric Irish UnitsandHospitals Census 2006. 4.1 andgender.type Hospital Numberswithpercentages. hospitals hasincreasedfrom10%in1981and1991to17%2006. hospitals andtheirreplacementbygeneralhospitalpsychiatricunits.Theproportionofpatientsresidentinprivate residents inpsychiatrichospitalsfrom90%1981to52%2006.Thisislinewiththepolicyofclosing in generalhospitalpsychiatricunitsfrom3%1981to23%2006,withacorrespondingdecreasetheproportionof units and17%wereinprivatehospitals(Table 4.1).Therehasbeenaconsiderableincreaseintheproportionofresidents Fifty-two percent of patients were resident in psychiatric hospitals on census night, 23% were in general hospital psychiatric reporting totheNPIRS. Since thepreviouscensuswascarriedoutin2001,fournewgeneralhospitalpsychiatricunitshaveopened,andallare 4.type Hospital Carraig Mórisanintensivecareandrehabilitationunit. St Joseph’s IntellectualDisabilityServiceislocatedatStIta’s Hospital,Portrane. Total St Joseph’s IntellectualDisabilityService Carraig Mór, Cork Central MentalHospital,Dundrum Private hospitals Psychiatric hospitals General hospitalpsychiatricunits a b 1,859 1,012 Male 115 235 405 25 67 Numbers Female 1,530 337 743 380 47 16 7 3,389 1,755 Total 162 572 785 41 74 Male 54.9 71.0 41.1 57.7 51.6 61.0 90.5 Percentages Female 29.0 58.9 42.3 48.4 45.1 39.0 9.5 100.0 Total 16.9 51.8 23.2 4.8 1.2 2.2 47
Irish Psychiatric Units and Hospitals Census 2006 48 Irish Psychiatric Units and Hospitals Census 2006 49.9 days,andgeneralhospital psychiatricunits,at49.1days. hospitals hadthehighestaveragenumberofdaysoncensus night, at89.1days;theywerefollowedbyprivatehospitals, for generalhospitalpsychiatricunitswas31%;privatehospitals thisfigurewas20%(Table 4.9).Patientsinpsychiatric On censusnight,patientsresidentinpsychiatrichospitalsaccounted for44%ofin-patientdays.Thecorrespondingfigure private hospitalsandpsychiatricwere81%33% respectively. patients residentingeneralhospitalpsychiatricunitshadbeen inhospitalforlessthanoneyear. Thecorrespondingdatafor the correspondingdataforprivatehospitalsremainedunchanged at0.3%inthesameperiod.Oncensusnight,96%of The numberofpatientsresidentinpsychiatrichospitalsfor25 yearsormoredecreasedfrom20%in2001to16%2006; was 7.5%;forgeneralhospitalpsychiatricunitsthisfigure was lessthan1%. patients i.e.hadbeeninhospitalforfiveyearsormoreoncensusnight.Thecorrespondingproportionprivatehospitals psychiatric unitsthisfigurewas4%.Forty-fourpercentofpatientsresidentinhospitalswereoldlong-stay in hospitalforoneyearormore(Table 4.8).Thecorrespondingdataforprivatehospitalswas19%;generalhospital Just overtwo-thirds(67%)ofpatientsresidentinpsychiatrichospitalsoncensusnightwerelong-stayi.e.hadbeen Length ofstay since 2001intheproportionofnon-voluntaryresidentpatientsallhospitaltypes. were non-voluntary, while7%ofpatientsinprivatehospitalswerenon-voluntary(Table 4.7).Thisrepresentsanincrease Over one-quarter(26%)ofpatientsresidentingeneralhospitalpsychiatricunitsand23%thosehospitals Legal status Figure 4.1 general hospitalpsychiatricunits,for12%ofpatientsinhospitals,and10%privatehospitals. Hospital, Dundrumhadadiagnosisofschizophrenia.Depressivedisordersaccountedfor27%patientsresidentin for 5%ofthoseinprivatehospitals(Figure3.1andTable 4.6).SeventypercentofpatientsresidentintheCentralMental accounted for46%ofpatientsresidentinpsychiatrichospitals,32%thosegeneralhospitalunitsand There wereconsiderablevariationsintheproportionsofvariousdiagnosticgroupingsbyhospitaltype.Sschizophrenia Diagnosis 10 20 30 40 50 60 70 80 10.0 20.0 30.0 40.0 50.0 60.0 70.0 80.0 0.0 0 Irish PsychiatricIrish UnitsandHospitals Census 2006. diagnosis. by selected type Hospital Percentages. 31.8 psy Gener chiatric units 27.0 Alcoholic disorders Schizophrenia al hospita 6.1 0.4 l 46.3 Psy hospital 11.8 chiatric 4.7 Intellectual disability Depressive disorder s 7.8 5.4 10.0 hospital Priv s at 5.2 e s 0.9 Hospital, 70.3 Ce ntral Mental 10.8 Dundrum 4.1 1.4 Ca 29.3 rr aig Mó 19.5 0.0 r,
Co rk 4.9 Intellectual Disability Disability Intellectual 3.1 St 0.0 . Ser Joseph vice 0.6 ’s
63.6
49
Irish Psychiatric Units and Hospitals Census 2006 48 Irish Psychiatric Units and Hospitals Census 2006
Table 4.2 Irish Psychiatric Units and Hospitals Census 2006. Hospital type and age. Numbers with percentages.
Numbers Under 16 16 - 19 20 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 years years years years years years years years years and over Unspecified Total General hospital psychiatric units 0 17 62 158 147 155 120 79 47 0 785 Psychiatric hospitals 1 8 41 107 200 304 359 357 378 0 1,755 Private hospitals 6 12 29 57 72 103 90 83 120 0 572 Central Mental Hospital, Dundrum 0 0 11 13 17 20 9 3 0 1 74 Carraig Mór, Cork 0 0 2 2 12 10 10 4 1 0 41 St Joseph’s Intellectual Disability Service 0 0 5 16 35 45 24 26 11 0 162 Total 7 37 150 353 483 637 612 552 557 1 3,389 Percentages General hospital psychiatric units 0.0 2.2 7.9 20.1 18.7 19.7 15.3 10.1 6.0 0.0 100.0 Psychiatric hospitals 0.1 0.5 2.3 6.1 11.4 17.3 20.5 20.3 21.5 0.0 100.0 Private hospitals 1.0 2.1 5.1 10.0 12.6 18.0 15.7 14.5 21.0 0.0 100.0 Central Mental Hospital, Dundrum 0.0 0.0 14.9 17.6 23.0 27.0 12.2 4.1 0.0 1.4 100.0 Carraig Mór, Cork 0.0 0.0 4.9 4.9 29.3 24.4 24.4 9.8 2.4 0.0 100.0 St Joseph’s Intellectual Disability Service 0.0 0.0 3.1 9.9 21.6 27.8 14.8 16.0 6.8 0.0 100.0 Total 0.2 1.1 4.4 10.4 14.3 18.8 18.1 16.3 16.4 0.0 100.0 49
Irish Psychiatric Units and Hospitals Census 2006 50 Irish Psychiatric Units and Hospitals Census 2006 Table 4.4 Note: Therewereanadditionaleightpatientsunder18residentinchildren’s centres. Table3 4.
Total Total St Joseph’s IntellectualDisabilityService Carraig Mór, Cork Central MentalHospital,Dundrum Private hospitals Psychiatric hospitals General hospitalpsychiatricunits Total St Joseph’s IntellectualDisabilityService Carraig Mór, Cork Central MentalHospital,Dundrum Private hospitals Psychiatric hospitals General hospitalpsychiatricunits St Joseph’s IntellectualDisabilityService Carraig Mór, Cork Central MentalHospital,Dundrum Private hospitals Psychiatric hospitals General hospitalpsychiatricunits Irish Psychiatric Irish UnitsandHospitals Census 2006. age groups. andselected type Hospital Numberswith percentages. Irish Psychiatric Units and Hospitals Census 2 006. Hospital type and marital status. Numbers with percentages. Under 16 Single 1,303 2,229 65.8 99.4 70.7 10.8 40.9 74.2 62.9 years 234 494 161 29 8 0 0 0 7 6 1 0 Married 17.8 37.6 12.8 19.6 215 225 154 602 0.0 7.3 6.8 5 0 3 16 -17 years 15 Widowed 0 0 0 5 2 8 12.2 12.4 Percentages 223 6.6 0.0 0.0 5.6 6.1 71 99 48 Numbers and over 0 0 5 18 years 3,366 1,752 Divorced 162 561 777 41 73 1.3 0.0 2.4 0.0 1.6 0.9 2.3 16 18 44 0 9 0 1 Unspecified Unspecified 0 0 0 0 0 1 1 82.4 112 291 8.6 0.6 7.3 7.5 6.4 9.0 61 43 71 1 3 100.0 100.0 100.0 100.0 100.0 100.0 100.0 3,389 1,755 3,389 1,755 Total Total 162 572 785 162 572 785 41 74 41 74 51
Irish Psychiatric Units and Hospitals Census 2006 50 Irish Psychiatric Units and Hospitals Census 2006
Table 4.5 Irish Psychiatric Units and Census 2006. Hospital type and socio-economic group. Numbers with percentages.
Numbers Agricultural Higher Lower Employers and Own account Non- Manual Semi- Farmers workers professional professional managers workers manual skilled skilled Unskilled Unspecified Total General hospital psychiatric units 42 6 15 45 14 6 116 72 74 93 302 785 Psychiatric hospitals 97 68 17 50 15 3 170 99 113 287 836 1755 Private hospitals 1 1 22 52 24 1 74 29 13 9 346 572 Central Mental Hospital, Dundrum 0 0 0 0 0 0 0 0 0 0 74 74 Carraig Mór, Cork 6 0 1 0 3 0 9 3 6 12 1 41 St Joseph’s Intellectual Disability Service 0 0 0 0 0 0 0 0 0 0 162 162 Total 146 75 55 147 56 10 369 203 206 401 1,721 3,389 Percentages (row and column) General hospital psychiatric units 5.4 0.8 1.9 5.7 1.8 0.8 14.8 9.2 9.4 11.8 38.5 100.0 28.8 8.0 27.3 30.6 25.0 60.0 31.4 35.5 35.9 23.2 17.5 23.2 Psychiatric hospitals 5.5 3.9 1.0 2.8 0.9 0.2 9.7 5.6 6.4 16.4 47.6 100.0 66.4 90.7 30.9 34.0 26.8 30.0 46.1 48.8 54.9 71.6 48.6 51.8 Private hospitals 0.2 0.2 3.8 9.1 4.2 0.2 12.9 5.1 2.3 1.6 60.5 100.0 0.7 1.3 40.0 35.4 42.9 10.0 20.1 14.3 6.3 2.2 20.1 16.9 Central Mental Hospital, Dundrum 14.6 0.0 2.4 0.0 7.3 0.0 22.0 7.3 14.6 29.3 2.4 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 4.3 2.2 Carraig Mór, Cork 14.6 0.0 2.4 0.0 7.3 0.0 22.0 7.3 14.6 29.3 2.4 100.0 4.1 0.0 0.7 0.0 2.1 0.0 6.2 2.1 4.1 8.2 0.7 28.1 St Joseph’s Intellectual Disability Service 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 100.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 9.4 4.8 Total 4.3 2.2 1.6 4.3 1.7 0.3 10.9 6.0 6.1 11.8 50.8 100.0 51
Irish Psychiatric Units and Hospitals Census 2006 52 Irish Psychiatric Units and Hospitals Census 2006
Table 4.6 Irish Psychiatric Units and Hospitals Census 2006. Hospital type and diagnosis. Numbers with percentages.
St Joseph’s General hospital Psychiatric Central Mental Intellectual psychiatric units hospitals Private hospitals Hospital, Dundrum Carraig Mór, Cork Disability Service Total Number % Number % Number % Number % Number % Number % Number % Organic mental disorders 17 2.2 123 7.0 94 16.4 0 0.0 1 2.4 0 0.0 235 6.9 Alcoholic disorders 48 6.1 82 4.7 30 5.2 3 4.1 0 0.0 1 0.6 164 4.8 Other drug disorders 12 1.5 12 0.7 0 0.0 1 1.4 1 2.4 0 0.0 26 0.8 Schizophrenia, schizotypal and delusional disorders 250 31.8 813 46.3 31 5.4 52 70.3 12 29.3 5 3.1 1,163 34.3 Depressive disorders 212 27.0 207 11.8 57 10.0 8 10.8 8 19.5 0 0.0 492 14.5 Mania 83 10.6 133 7.6 46 8.0 3 4.1 9 22.0 1 0.6 275 8.1 Neuroses 17 2.2 33 1.9 5 0.9 0 0.0 2 4.9 1 0.6 58 1.7 Eating disorders 7 0.9 4 0.2 7 1.2 0 0.0 0 0.0 0 0.0 18 0.5 Personality and behavioural disorders 15 1.9 43 2.5 2 0.3 4 5.4 6 14.6 0 0.0 70 2.1 Intellectual disability 3 0.4 137 7.8 5 0.9 1 1.4 2 4.9 103 63.6 251 7.4 Development disorders 0 0.0 10 0.6 1 0.2 1 1.4 0 0.0 1 0.6 13 0.4 Behavioural and emotional disorders of childhood and adolescence 1 0.1 3 0.2 1 0.2 0 0.0 0 0.0 2 1.2 7 0.2 Other and unspecified 120 15.3 155 8.8 293 51.2 1 1.4 0 0.0 48 29.6 617 18.2 Total 785 100.0 1,755 100.0 572 100.0 74 100.0 41 100.0 162 100.0 3,389 100.0
Table 4.7 Irish Psychiatric Units and Hospitals Census 2006. Hospital type and legal status on census night. Numbers with percentages.
Numbers Percentages Voluntary Non-voluntary Total Voluntary Non-voluntary Total General hospital psychiatric units 578 207 785 73.6 26.4 100.0 Psychiatric hospitals 1,349 406 1,755 76.9 23.1 100.0 Private hospitals 532 40 572 93.0 7.0 100.0 Central Mental Hospital, Dundrum 2 72 74 2.7 97.3 100.0 Carraig Mór, Cork 25 16 41 61.0 39.0 100.0 St Joseph’s Intellectual Disability Service 159 3 162 98.1 1.9 100.0 Total 2645 744 3389 78.0 22.0 100.0 53
Irish Psychiatric Units and Hospitals Census 2006 52 Irish Psychiatric Units and Hospitals Census 2006
Table 4.8 Irish Psychiatric Units and Hospitals Census 2006. Hospital type and length of stay. Numbers with percentages.
Numbers Under 1 1-< 2 2-< 4 1-< 3 3 months- 1-< 5 5-< 10 10-< 25 25 years week weeks weeks months < 1 year years years years and over Total General hospital psychiatric units 145 116 135 249 108 31 1 0 0 785 Psychiatric hospitals 95 61 63 157 205 400 231 267 276 1,755 Private hospitals 87 56 104 148 67 67 28 13 2 572 Central Mental Hospital, Dundrum 1 1 1 10 7 19 16 10 9 74 Carraig Mór, Cork 2 1 4 1 9 6 4 12 2 41 St Joseph’s Intellectual Disability Service 0 0 0 3 8 25 21 39 66 162 Total 330 235 307 568 404 548 301 341 355 3,389 Percentages (Row & Column) General hospital psychiatric units 18.5 14.8 17.2 31.7 13.8 3.9 0.1 0.0 0.0 100.0 43.9 49.4 44.0 43.8 26.7 5.7 0.3 0.0 0.0 23.2 Psychiatric hospitals 5.4 3.5 3.6 8.9 11.7 22.8 13.2 15.2 15.7 100.0 28.8 26.0 20.5 27.6 50.7 73.0 76.7 78.3 77.7 51.8 Private Hospitals 15.2 9.8 18.2 25.9 11.7 11.7 4.9 2.3 0.3 100.0 26.4 23.8 33.9 26.1 16.6 12.2 9.3 3.8 0.6 16.9 Central Mental Hospital, Dundrum 1.4 1.4 1.4 13.5 9.5 25.7 21.6 13.5 12.2 100.0 0.3 0.4 0.3 1.8 1.7 3.5 5.3 2.9 2.5 2.2 Carraig Mór, Corka 4.9 2.4 9.8 2.4 22.0 14.6 9.8 29.3 4.9 100.0 0.6 0.4 1.3 0.2 2.2 1.1 1.3 3.5 0.6 1.2 St Joseph’s Intellectual Disability Service 9.7 6.9 9.1 16.8 11.9 16.2 8.9 10.1 10.5 100.0 0.0 0.0 0.0 0.5 2.0 4.6 7.0 11.4 18.6 4.8 Total 9.7 6.9 9.1 16.8 11.9 16.2 8.9 10.1 10.5 100.0 a Some patients in Carraig Mór were transferred from other services and the length of stay includes time spent in other services. 53
Irish Psychiatric Units and Hospitals Census 2006 54 Irish Psychiatric Units and Hospitals Census 2006 a Table 4.9 Total St Joseph’s IntellectualDisabilityService Carraig Mór, Cork Central MentalHospital,Dundrum Private hospitals Psychiatric hospitals General hospitalpsychiatricunits thus excluded. Patients withalengthofstayoneyearormorewereexcludedfromthisanalysis.Forty-sixpercentpatients Irish PsychiatricIrish UnitsandHospitals Census 2006. Analysis ofin-patient daystype. by hospital with percentages. In-patient days Number 117,596 23,051 51,764 36,955 2,229 1,700 1,897 100.0 19.6 44.0 31.4 1.9 1.4 1.6 % Average numberofdays 202.6 100.0 63.8 94.9 49.9 89.1 49.1 Median numberofdays a Numbers
223 105 30 62 24 46 24 55
Irish Psychiatric Units and Hospitals Census 2006 54 Irish Psychiatric Units and Hospitals Census 2006 Table 5.1 This chapterpresentsnumericaldataonindividualpsychiatricunitsandhospitalsbyage,diagnosislengthofstay. 5. Individual psychiatric unitsandhospitals St Vincent’s Hospital,ElmPark Dublin SouthEast Mater MisericordiaeHospital,Dublin Dublin NorthCentral Connolly Hospital,Dublin North West Dublin Tallaght Hospital,Dublin Dublin SouthWest andDublinWest St James’s Hospital,Dublin Dublin SouthCity Midland RegionalHospital,Portlaoise Laois/Offaly Naas GeneralHospital Kildare/West Wicklow Regional Hospital,Limerick Limerick Our Lady’s Hospital, Navan Meath Cavan GeneralHospital Cavan/Monaghan Ennis GeneralHospital Clare St Joseph’s Hospital,Clonmel Tipperary Letterkenny GeneralHospital Donegal Irish PsychiatricIrish UnitsandHospitals Census 2006. General hospital psychiatric units. Age groups. Numbers with percentages. Under 20 years 0.0 0.0 0.0 8.3 0.0 5.4 0.0 0.0 5.3 0.0 0.0 0.0 3.4 0 2 0 0 3 0 2 0 0 0 0 0 2 0-44 years20-44 58.3 52.6 47.4 50.0 55.4 41.0 65.6 32.4 31.6 62.5 42.4 48.9 8.3 20 12 27 31 16 21 12 10 12 22 25 7 1 45-64 years45-64 23.7 41.7 41.7 29.8 32.1 31.3 44.7 30.8 66.7 45.9 37.8 31.3 32.2 17 10 10 18 12 17 17 17 19 9 5 5 8 65 years and 23.7 22.8 28.2 18.4 25.0 21.6 22.0 13.3 over 0.0 0.0 7.1 3.1 6.3 13 11 13 0 9 0 4 1 7 1 3 8 6 Unspecified 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0 0 0 0 0 0 0 0 0 0 0 0 0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Total 38 12 57 24 32 56 39 37 38 45 16 12 59 55
Irish Psychiatric Units and Hospitals Census 2006 56 Irish Psychiatric Units and Hospitals Census 2006 Table 5.1 Waterford RegionalHospital Waterford St Luke’s Hospital,Kilkenny Carlow/Kilkenny Cork UniversityHospital South Lee Tralee GeneralHospital Kerry Bantry GeneralHospital West Cork Mercy Hospital,Cork North Lee University CollegeHospital,Galway West Galway Roscommon GeneralHospital Roscommon Mayo GeneralHospital Mayo Total Irish PsychiatricIrish UnitsandHospitals Census 2006. General hospital psychiatric units. Age groups. Numbers with percentages (continued). Under 20 years 1.9 0.0 0.0 3.9 2.3 5.9 3.9 2.7 2.2 0.0 17 1 1 0 0 2 2 1 0 1 0-44 years20-44 62.1 44.4 50.0 49.0 47.7 41.2 59.5 35.3 46.8 35.5 367 18 24 21 25 21 22 11 3 6 45-64 years45-64 29.6 27.3 24.1 50.0 35.3 39.2 52.9 35.0 48.4 29.7 275 16 18 12 20 11 15 7 3 9 65 years and 13.8 24.1 22.7 11.8 15.7 16.1 16.1 over 126 0.0 8.1 5.9 13 10 4 0 6 8 1 5 3 Unspecified 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0 0 0 0 0 0 0 0 0 0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Total 785 54 29 51 44 17 51 37 31 6 57
Irish Psychiatric Units and Hospitals Census 2006 56 Irish Psychiatric Units and Hospitals Census 2006 Table2 5. St Vincent’s Hospital,Fairview Dublin NorthCentral St Ita’s Hospital,Portrane Dublin North Cluain MhuireFamilyCentre,Dublin Dun Laoghaire St Loman’s Hospital,Dublin Dublin SouthWest andDublinWest St Brendan’s Hospital,Dublin North West Dublin Newcastle Hospital,Greystones Wicklow St Brigid’s Hospital,Ardee Louth St Joseph’s Hospital,Limerick Limerick St Loman’s Hospital,Mullingar Longford/Westmeath St Fintan’s Hospital,Portlaoise Laois/Offaly St Dympna’s Hospital,Carlow St Canice’s Hospital,Kilkenny Carlow/Kilkenny St Conal’s Hospital,Letterkenny Donegal Mental HealthService,Sligo Sligo/Leitrim St Davnet’s Hospital,Monaghan Cavan/Monaghan Irish PsychiatricIrish UnitsandHospitals Census 2006. Psychiatric hospitals. Age groups. Numberswith percentages. Under 20 years 0.0 1.8 0.0 0.0 2.7 0.0 2.0 0.0 0.0 0.0 0.0 0.0 0.0 2.2 0.0 0 0 0 2 0 1 0 0 3 0 1 0 0 0 0 0-44 years20-44 25.6 37.8 30.4 56.8 27.3 23.1 21.2 17.6 25.9 12.5 33.3 9.7 0.0 8.0 2.9 24 32 42 12 21 14 18 27 15 6 3 1 8 0 2 45-64 years45-64 30.4 63.6 53.2 44.3 34.6 35.1 35.9 57.6 61.3 57.8 11.4 25.9 48.4 21.2 68.0 14 59 35 38 13 18 49 55 19 26 14 31 11 17 4 65 years and 25.3 44.0 42.3 44.4 29.0 85.7 48.1 21.2 78.8 24.0 39.1 over 7.2 5.4 9.1 6.7 20 55 22 18 68 30 26 25 41 2 8 2 9 3 6 Unspecified 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Total 111 125 153 22 79 37 85 31 52 45 35 54 64 52 25 57
Irish Psychiatric Units and Hospitals Census 2006 58 Irish Psychiatric Units and Hospitals Census 2006 Table 5. Table Psychiatric3 Irish 5. UnitsandHospitals Census 2006. Private hospitals. Age groups. Numberswithpercentages. St Luke’s Hospital,Clonmel Tipperary St Mary’s Hospital,Castlebar Mayo St Brigid’s Hospital,Ballinasloe East Galway St Finan’s Hospital,Killarney Kerry St Stephen’s Hospital,Cork North Cork St Senan’s Hospital,Enniscorthy Wexford St Otteran’s Hospital,Waterford Waterford Central MentalHospital,Dundrum Other services Total psychiatrichospitals Carraig Mór, Cork Service St Joseph’s IntellectualDisability Bloomfield Hospital,Dublin Total St Patrick’s Hospital,Dublin St JohnofGodHospital,Dublin Palmerstown House,Dublin Kylemore Clinic,Dublin Hampstead andHighfieldHospitals,Dublin 2
Irish Psychiatric Units and Hospitals Census (continued). Under 20 Under 20 years years 16.7 0.0 0.7 0.0 0.0 0.0 0.0 0.6 0.4 0.0 0.0 0.0 0.0 0.0 0.0 3.1 2.2 8.3 18 11 0 1 0 0 0 1 0 0 9 0 0 2 6 1 0 0 0 006. Psychiatric hospitals. Age groups. Numbers with percentages 0-44 years20-44 0-44 years20-44 10.2 27.3 15.9 16.6 11.9 10.1 22.9 22.7 39.0 34.6 55.4 461 27.6 39.6 32.3 66.7 158 110 19 14 30 17 24 11 41 16 56 2.9 0.0 0.0 43 8 4 1 0 0 45-64 years45-64 45-64 years45-64 34.3 29.1 25.2 42.1 27.0 35.4 42.6 39.2 45.8 38.4 48.8 781 35.3 10.5 22.9 33.7 42.4 33.8 16.7 193 118 28 47 32 27 61 43 22 20 69 29 12 45 1 9 8 65 years and 65 years and 54.7 43.6 58.9 41.4 60.4 54.4 31.3 22.8 61.8 89.5 77.1 38.4 12.2 35.5 15.8 25.6 over over 780 203 4.1 0.0 43 75 48 63 60 96 15 37 21 77 27 44 34 3 5 0 Unspecified Unspecified 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 1.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 2,032 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Total Total 137 110 107 145 159 162 572 278 133 79 48 41 74 34 86 35 6
59
Irish Psychiatric Units and Hospitals Census 2006 58 Irish Psychiatric Units and Hospitals Census 2006
Table 5.4 Irish Psychiatric Units and Hospitals Census 2006. General hospital psychiatric units. Diagnosis. Numbers with percentages.
Behavioural Schizophrenia, Personality and emotional Organic Other schizotypal Eating and disorders of mental Alcoholic drug and delusional Depressive dis- behavioural Intellectual Development childhood & Other and disorders disorders disorders disorders disorders Mania Neuroses orders disorders disability disorders adolescence unspecified Total Dublin South East St Vincent’s Hospital, 1 0 0 17 12 4 1 2 1 0 0 0 0 38 Elm Park 2.6 0.0 0.0 44.7 31.6 10.5 2.6 5.3 2.6 0.0 0.0 0.0 0.0 100.0 Dublin North Central Mater Misericordiae 0 1 1 5 2 2 0 0 0 0 0 0 1 12 Hospital, Dublin 0.0 8.3 8.3 41.7 16.7 16.7 0.0 0.0 0.0 0.0 0.0 0.0 8.3 100.0 North West Dublin Connolly Hospital, 0 4 1 11 2 2 0 2 1 0 0 0 1 24 Dublin 0.0 16.7 4.2 45.8 8.3 8.3 0.0 8.3 4.2 0.0 0.0 0.0 4.2 100.0 Dublin South City St James’s Hospital, 1 4 0 27 19 5 0 0 0 0 0 0 1 57 Dublin 1.8 7.0 0.0 47.4 33.3 8.8 0.0 0.0 0.0 0.0 0.0 0.0 1.8 100.0 Dublin South West and Dublin West Tallaght Hospital, 5 1 1 28 13 2 4 0 1 0 0 1 0 56 Dublin 8.9 1.8 1.8 50.0 23.2 3.6 7.1 0.0 1.8 0.0 0.0 1.8 0.0 100.0 Kildare/West Wicklow Naas General 0 0 1 16 4 0 0 0 1 0 0 0 10 32 Hospital 0.0 0.0 3.1 50.0 12.5 0.0 0.0 0.0 3.1 0.0 0.0 0.0 31.3 100.0 59
Irish Psychiatric Units and Hospitals Census 2006 60 Irish Psychiatric Units and Hospitals Census 2006
Table 5.4 Irish Psychiatric Units and Hospitals Census 2006. General hospital psychiatric units. Diagnosis. Numbers with percentages (continued).
Behavioural Schizophrenia, Personality and emotional Organic Other schizotypal Eating and disorders of mental Alcoholic drug and delusional Depressive dis- behavioural Intellectual Development childhood & Other and disorders disorders disorders disorders disorders Mania Neuroses orders disorders disability disorders adolescence unspecified Total Laois/Offaly Midland Regional 3 1 0 12 15 3 0 0 4 1 0 0 0 39 Hospital, Portlaoise 7.7 2.6 0.0 30.8 38.5 7.7 0.0 0.0 10.3 2.6 0.0 0.0 0.0 100.0 Limerick Regional Hospital, 0 3 0 11 15 4 3 0 1 1 0 0 0 38 Limerick 0.0 7.9 0.0 28.9 39.5 10.5 7.9 0.0 2.6 2.6 0.0 0.0 0.0 100.0 Clare Ennis General 1 5 1 15 6 5 2 0 1 1 0 0 0 37 Hospital 2.7 13.5 2.7 40.5 16.2 13.5 5.4 0.0 2.7 2.7 0.0 0.0 0.0 100.0 Cavan/Monaghan Cavan General 1 0 0 5 2 4 0 0 0 0 0 0 0 12 Hospital 8.3 0.0 0.0 41.7 16.7 33.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 Meath Our Lady’s Hospital, 1 1 0 6 5 3 0 0 0 0 0 0 0 16 Navan 6.3 6.3 0.0 37.5 31.3 18.8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 Donegal Letterkenny General 0 3 1 18 15 5 1 1 1 0 0 0 0 45 Hospital 0.0 6.7 2.2 40.0 33.3 11.1 2.2 2.2 2.2 0.0 0.0 0.0 0.0 100.0 Tipperary St Joseph’s Hospital, 1 6 1 10 32 9 0 0 0 0 0 0 0 59 Clonmel 1.7 10.2 1.7 16.9 54.2 15.3 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 Waterford Waterford Regional 1 3 2 12 25 8 0 1 2 0 0 0 0 54 Hospital 1.9 5.6 3.7 22.2 46.3 14.8 0.0 1.9 3.7 0.0 0.0 0.0 0.0 100.0 61
Irish Psychiatric Units and Hospitals Census 2006 60 Irish Psychiatric Units and Hospitals Census 2006
Table 5.4 Irish Psychiatric Units and Hospitals Census 2006. General hospital psychiatric units. Diagnosis. Numbers with percentagess (continued).
Behavioural Schizophrenia, Personality and emotional Organic Other schizotypal Eating and disorders of mental Alcoholic drug and delusional Depressive dis- behavioural Intellectual Development childhood & Other and disorders disorders disorders disorders disorders Mania Neuroses orders disorders disability disorders adolescence unspecified Total Carlow/Kilkenny St Luke’s Hospital, 0 0 0 0 1 0 0 0 1 0 0 0 27 29 Kilkenny 0.0 0.0 0.0 0.0 3.4 0.0 0.0 0.0 3.4 0.0 0.0 0.0 93.1 100.0 South Lee Cork University 1 0 2 18 13 6 1 0 0 0 0 0 3 44 Hospital 2.3 0.0 4.5 40.9 29.5 13.6 2.3 0.0 0.0 0.0 0.0 0.0 6.8 100.0 North Lee Mercy Hospital, Cork 0 7 1 18 13 8 2 0 1 0 0 0 1 51 0.0 13.7 2.0 35.3 25.5 15.7 3.9 0.0 2.0 0.0 0.0 0.0 2.0 100.0 West Cork Bantry General 0 0 0 0 0 0 0 0 0 0 0 0 6 6 Hospital 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 100.0 Kerry Tralee General Hospital 0 3 0 5 5 3 2 1 0 0 0 0 32 51 0.0 5.9 0.0 9.8 9.8 5.9 3.9 2.0 0.0 0.0 0.0 0.0 62.7 100.0 Roscommon Roscommon General 1 2 0 5 5 3 1 0 0 0 0 0 0 17 Hospital 5.9 11.8 0.0 29.4 29.4 17.6 5.9 0.0 0.0 0.0 0.0 0.0 0.0 100.0 West Galway University College 0 0 0 0 0 0 0 0 0 0 0 0 37 37 Hospital, Galway 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 100.0 Mayo Mayo General Hospital 0 4 0 11 8 7 0 0 0 0 0 0 1 31 0.0 12.9 0.0 35.5 25.8 22.6 0.0 0.0 0.0 0.0 0.0 0.0 3.2 100.0 Total 17 48 12 250 212 83 17 7 15 3 0 1 120 785 2.2 6.1 1.5 31.8 27.0 10.6 2.2 0.9 1.9 0.4 0.0 0.1 15.3 100.0 61
Irish Psychiatric Units and Hospitals Census 2006 62 Irish Psychiatric Units and Hospitals Census 2006
Table 5.5 Irish Psychiatric Units and Hospitals Census 2006. Psychiatric hospitals. Diagnosis. Numbers with percentages.
Behavioural Schizophrenia, Personality and emotional Organic Other schizotypal Eating and disorders of mental Alcoholic drug and delusional Depressive dis- behavioural Intellectual Development childhood & Other and disorders disorders disorders disorders disorders Mania Neuroses orders disorders disability disorders adolescence unspecified Total Dublin North St Ita’s Hospital, 13 2 2 46 31 8 2 1 0 1 0 0 19 125 Portrane 10.4 1.6 1.6 36.8 24.8 6.4 1.6 0.8 0.0 0.8 0.0 0.0 15.2 100.0 Dublin North Central St Vincent’s 1 5 2 44 8 10 1 0 0 0 0 0 8 79 Hospital, Fairview 1.3 6.3 2.5 55.7 10.1 12.7 1.3 0.0 0.0 0.0 0.0 0.0 10.1 100.0 North West Dublin St Brendan’s 0 7 0 70 12 6 0 0 9 5 0 0 2 111 Hospital, Dublin 0.0 6.3 0.0 63.1 10.8 5.4 0.0 0.0 8.1 4.5 0.0 0.0 1.8 100.0 Dublin South West and Dublin West St Loman’s Hospital, 0 0 0 12 4 2 0 0 2 1 0 0 1 22 Dublin 0.0 0.0 0.0 54.5 18.2 9.1 0.0 0.0 9.1 4.5 0.0 0.0 4.5 100.0 Dun Laoghaire Cluain Mhuire Family Centre, 0 2 0 4 5 13 1 0 0 0 0 1 11 37 Dublin 0.0 5.4 0.0 10.8 13.5 35.1 2.7 0.0 0.0 0.0 0.0 2.7 29.7 100.0 Wicklow Newcastle Hospital, 11 9 0 20 2 4 2 1 0 3 0 0 0 52 Greystones 21.2 17.3 0.0 38.5 3.8 7.7 3.8 1.9 0.0 5.8 0.0 0.0 0.0 100.0 Laois/Offaly St Fintan’s Hospital, 2 1 0 16 6 2 0 1 0 2 0 0 1 31 Portlaoise 6.5 3.2 0.0 51.6 19.4 6.5 0.0 3.2 0.0 6.5 0.0 0.0 3.2 100.0 63
Irish Psychiatric Units and Hospitals Census 2006 62 Irish Psychiatric Units and Hospitals Census 2006
Table 5.5 Irish Psychiatric Units and Hospitals Census 2006. Psychiatric hospitals. Diagnosis. Numbers with percentages (continued). Behavioural Schizophrenia, Personality and emotional Organic Other schizotypal Eating and disorders of mental Alcoholic drug and delusional Depressive dis- behavioural Intellectual Development childhood & Other and disorders disorders disorders disorders disorders Mania Neuroses orders disorders disability disorders adolescence unspecified Total Longford/ Westmeath St Loman’s Hospital, 15 4 0 75 25 7 3 0 10 6 0 0 8 153 Mullingar 9.8 2.6 0.0 49.0 16.3 4.6 2.0 0.0 6.5 3.9 0.0 0.0 5.2 100.0 Limerick St Joseph’s Hospital, 0 3 1 42 4 12 2 0 4 17 0 0 0 85 Limerick 0.0 3.5 1.2 49.4 4.7 14.1 2.4 0.0 4.7 20.0 0.0 0.0 0.0 100.0 Louth St Brigid’s Hospital, 4 3 0 34 3 6 3 0 0 1 0 0 0 54 Ardee 7.4 5.6 0.0 63.0 5.6 11.1 5.6 0.0 0.0 1.9 0.0 0.0 0.0 100.0 Cavan/Monaghan St Davnet’s Hospital, 5 2 0 15 3 5 0 0 0 0 4 0 1 35 Monaghan 14.3 5.7 0.0 42.9 8.6 14.3 0.0 0.0 0.0 0.0 11.4 0.0 2.9 100.0 Sligo/Leitrim Mental Health 0 2 0 21 10 11 0 0 1 0 0 0 0 45 Service, Sligo 0.0 4.4 0.0 46.7 22.2 24.4 0.0 0.0 2.2 0.0 0.0 0.0 0.0 100.0 Donegal St Conal’s Hospital, 0 1 0 18 1 0 0 0 0 5 0 0 0 25 Letterkenny 0.0 4.0 0.0 72.0 4.0 0.0 0.0 0.0 0.0 20.0 0.0 0.0 0.0 100.0 Carlow/Kilkenny St Canice’s Hospital, 3 4 0 20 9 1 0 0 1 3 0 0 11 52 Kilkenny 5.8 7.7 0.0 38.5 17.3 1.9 0.0 0.0 1.9 5.8 0.0 0.0 21.2 100.0 St Dympna’s 4 3 0 23 1 2 0 0 0 25 1 0 5 64 Hospital, Carlow 6.3 4.7 0.0 35.9 1.6 3.1 0.0 0.0 0.0 39.1 1.6 0.0 7.8 100.0 63
Irish Psychiatric Units and Hospitals Census 2006 64 Irish Psychiatric Units and Hospitals Census 2006
Table 5.5 Irish Psychiatric Units and Hospitals Census 2006. Psychiatric hospitals. Diagnosis. Numbers with percentages (continued).
Behavioural Schizophrenia, Personality and emotional Organic Other schizotypal Eating and disorders of mental Alcoholic drug and delusional Depressive dis- behavioural Intellectual Development childhood & Other and disorders disorders disorders disorders disorders Mania Neuroses orders disorders disability disorders adolescence unspecified Total Tipperary St Luke’s Hospital, 9 2 5 71 14 12 0 0 2 26 2 0 2 145 Clonmel 6.2 1.4 3.4 49.0 9.7 8.3 0.0 0.0 1.4 17.9 1.4 0.0 1.4 100.0 Waterford St Otteran’s 22 5 1 46 14 7 2 0 4 5 0 1 0 107 Hospital, Waterford 20.6 4.7 0.9 43.0 13.1 6.5 1.9 0.0 3.7 4.7 0.0 0.9 0.0 100.0 Wexford St Senan’s Hospital, 3 7 0 1 10 1 1 0 0 2 2 0 83 110 Enniscorthy 2.7 6.4 0.0 0.9 9.1 0.9 0.9 0.0 0.0 1.8 1.8 0.0 75.5 100.0 North Cork St Stephen’s 13 5 0 71 21 11 3 1 2 6 1 0 3 137 Hospital, Cork 9.5 3.6 0.0 51.8 15.3 8.0 2.2 0.7 1.5 4.4 0.7 0.0 2.2 100.0 Kerry St Finan’s Hospital, 4 5 0 47 4 6 1 0 3 9 0 0 0 79 Killarney 5.1 6.3 0.0 59.5 5.1 7.6 1.3 0.0 3.8 11.4 0.0 0.0 0.0 100.0 East Galway St Brigid’s Hospital, 13 9 1 91 11 5 12 0 3 13 0 1 0 159 Ballinasloe 8.2 5.7 0.6 57.2 6.9 3.1 7.5 0.0 1.9 8.2 0.0 0.6 0.0 100.0 Mayo St Mary’s Hospital, 1 1 0 26 9 2 0 0 2 7 0 0 0 48 Castlebar 2.1 2.1 0.0 54.2 18.8 4.2 0.0 0.0 4.2 14.6 0.0 0.0 0.0 100.0 65
Irish Psychiatric Units and Hospitals Census 2006 64 Irish Psychiatric Units and Hospitals Census 2006
Table 5.5 Irish Psychiatric Units and Hospitals Census 2006. Psychiatric hospitals. Diagnosis. Numbers with percentages (continued).
Behavioural Schizophrenia, Personality and emotional Organic Other schizotypal Eating and disorders of mental Alcoholic drug and delusional Depressive dis- behavioural Intellectual Development childhood & Other and disorders disorders disorders disorders disorders Mania Neuroses orders disorders disability disorders adolescence unspecified Total Other services Central Mental 0 3 1 52 8 3 0 0 4 1 1 0 1 74 Hospital, Dundum 0.0 4.1 1.4 70.3 10.8 4.1 0.0 0.0 5.4 1.4 1.4 0.0 1.4 100.0 St Joseph’s Intellectual 0 1 0 5 0 1 1 0 0 103 1 2 48 162 Disability Service 0.0 0.6 0.0 3.1 0.0 0.6 0.6 0.0 0.0 63.6 0.6 1.2 29.6 100.0 Carraig Mór, Cork 1 0 1 12 8 9 2 0 6 2 0 0 0 41 2.4 0.0 2.4 29.3 19.5 22.0 4.9 0.0 14.6 4.9 0.0 0.0 0.0 100.0 Total 124 86 14 882 223 146 36 4 53 243 12 5 204 2,032 6.1 4.2 0.7 43.4 11.0 7.2 1.8 0.2 2.6 12.0 0.6 0.2 10.0 100.0 65
Irish Psychiatric Units and Hospitals Census 2006 66 Irish Psychiatric Units and Hospitals Census 2006
Table 5.6 Irish Psychiatric Units and Hospitals Census 2006. Private hospitals. Diagnosis. Numbers with percentages.
Behavioural Schizophrenia, Personality and emotional Organic Other schizotypal Eating and disorders of mental Alcoholic drug and delusional Depressive dis- behavioural Intellectual Development childhood & Other and disorders disorders disorders disorders disorders Mania Neuroses orders disorders disability disorders adolescence unspecified Total Bloomfield Hospital, 13 1 0 9 6 2 2 0 0 0 0 0 2 35 Dublin 37.1 2.9 0.0 25.7 17.1 5.7 5.7 0.0 0.0 0.0 0.0 0.0 5.7 100.0 Hampstead and Highfield Hospitals, 54 6 0 8 10 4 0 0 1 3 0 0 0 86 Dublin 62.8 7.0 0.0 9.3 11.6 4.7 0.0 0.0 1.2 3.5 0.0 0.0 0.0 100.0 Kylemore Clinic, 18 0 0 10 2 1 1 0 0 1 0 0 1 34 Dublin 52.9 0.0 0.0 29.4 5.9 2.9 2.9 0.0 0.0 2.9 0.0 0.0 2.9 100.0 Palmerstown House, 1 0 0 1 0 0 0 0 1 1 1 1 0 6 Dublin 16.7 0.0 0.0 16.7 0.0 0.0 0.0 0.0 16.7 16.7 16.7 16.7 0.0 100.0 St John of God 8 23 0 3 39 39 2 7 0 0 0 0 12 133 Hospital, Dublin 6.0 17.3 0.0 2.3 29.3 29.3 1.5 5.3 0.0 0.0 0.0 0.0 9.0 100.0 St Patrick’s Hospital, 0 0 0 0 0 0 0 0 0 0 0 0 278 278 Dublin 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 100.0 100.0 Total 94 30 0 31 57 46 5 7 2 5 1 1 293 572 16.4 5.2 0.0 5.4 10.0 8.0 0.9 1.2 0.3 0.9 0.2 0.2 51.2 100.0 67
Irish Psychiatric Units and Hospitals Census 2006 66 Irish Psychiatric Units and Hospitals Census 2006
Table 5.7 Irish Psychiatric Units and Hospitals Census 2006. General hospital psychiatric units. Length of stay. Numbers with percentages.
Under 1 1-< 2 2-< 4 1-< 3 3 months- 1-< 5 5-< 10 10-< 25 25 years week weeks weeks months < 1 year years years years and over Total Dublin South East St Vincent’s Hospital, Elm Park 7 6 10 14 1 0 0 0 0 38 18.4 15.8 26.3 36.8 2.6 0.0 0.0 0.0 0.0 100.0 Dublin North Central Mater Misericordiae Hospital, Dublin 1 1 4 5 1 0 0 0 0 12 8.3 8.3 33.3 41.7 8.3 0.0 0.0 0.0 0.0 100.0 North West Dublin Connolly Hospital, Dublin 4 3 5 8 4 0 0 0 0 24 16.7 12.5 20.8 33.3 16.7 0.0 0.0 0.0 0.0 100.0 Dublin South City St James’s Hospital, Dublin 10 4 11 20 5 6 1 0 0 57 17.5 7.0 19.3 35.1 8.8 10.5 1.8 0.0 0.0 100.0 Dublin South West and Dublin West Tallaght Hospital, Dublin 6 7 7 18 15 3 0 0 0 56 10.7 12.5 12.5 32.1 26.8 5.4 0.0 0.0 0.0 100.0 Kildare/West Wicklow Naas General Hospital 10 2 8 5 6 1 0 0 0 32 31.3 6.3 25.0 15.6 18.8 3.1 0.0 0.0 0.0 100.0 Laois/Offaly Midland Regional Hospital, Portlaoise 10 5 3 15 4 2 0 0 0 39 25.6 12.8 7.7 38.5 10.3 5.1 0.0 0.0 0.0 100.0 Limerick Regional Hospital, Limerick 10 8 6 14 0 0 0 0 0 38 26.3 21.1 15.8 36.8 0.0 0.0 0.0 0.0 0.0 100.0 Clare Ennis General Hospital 5 5 6 11 8 2 0 0 0 37 13.5 13.5 16.2 29.7 21.6 5.4 0.0 0.0 0.0 100.0 67
Irish Psychiatric Units and Hospitals Census 2006 68 Irish Psychiatric Units and Hospitals Census 2006
Table 5.7 Irish Psychiatric Units and Hospitals Census 2006. General hospital psychiatric units. Length of stay. Numbers with percentages (continued).
Under 1 1-< 2 2-< 4 1-< 3 3 months- 1-< 5 5-< 10 10-< 25 25 years week weeks weeks months < 1 year years years years and over Total Cavan/Monaghan Cavan General Hospital 0 5 0 2 4 1 0 0 0 12 0.0 41.7 0.0 16.7 33.3 8.3 0.0 0.0 0.0 100.0 Meath Our Lady’s Hospital, Navan 1 3 2 5 3 2 0 0 0 16 6.3 18.8 12.5 31.3 18.8 12.5 0.0 0.0 0.0 100.0 Donegal Letterkenny General Hospital 12 5 4 10 12 2 0 0 0 45 26.7 11.1 8.9 22.2 26.7 4.4 0.0 0.0 0.0 100.0 Tipperary St Joseph’s Hospital, Clonmel 16 10 8 18 7 0 0 0 0 59 27.1 16.9 13.6 30.5 11.9 0.0 0.0 0.0 0.0 100.0 Waterford Waterford Regional Hospital 6 8 10 19 8 3 0 0 0 54 11.1 14.8 18.5 35.2 14.8 5.6 0.0 0.0 0.0 100.0 Carlow/Kilkenny St Luke’s Hospital, Kilkenny 3 8 5 9 3 1 0 0 0 29 10.3 27.6 17.2 31.0 10.3 3.4 0.0 0.0 0.0 100.0 South Lee Cork University Hospital 5 9 9 18 3 0 0 0 0 44 11.4 20.5 20.5 40.9 6.8 0.0 0.0 0.0 0.0 100.0 North Lee Mercy Hospital, Cork 8 7 11 13 9 3 0 0 0 51 15.7 13.7 21.6 25.5 17.6 5.9 0.0 0.0 0.0 100.0 West Cork Bantry General Hospital 0 3 1 2 0 0 0 0 0 6 0.0 50.0 16.7 33.3 0.0 0.0 0.0 0.0 0.0 100.0 Kerry Tralee General Hospital 10 5 10 16 8 2 0 0 0 51 19.6 9.8 19.6 31.4 15.7 3.9 0.0 0.0 0.0 100.0 69
Irish Psychiatric Units and Hospitals Census 2006 68 Irish Psychiatric Units and Hospitals Census 2006
Table 5.7 Irish Psychiatric Units and Hospitals Census 2006. General hospital psychiatric units. Length of stay. Numbers with percentages (continued).
Under 1 1-< 2 2-< 4 1-< 3 3 months- 1-< 5 5-< 10 10-< 25 25 years week weeks weeks months < 1 year years years years and over Total Roscommon Roscommon General Hospital 2 3 5 5 2 0 0 0 0 17 11.8 17.6 29.4 29.4 11.8 0.0 0.0 0.0 0.0 100.0 West Galway University College Hospital, Galway 14 5 5 9 1 3 0 0 0 37 37.8 13.5 13.5 24.3 2.7 8.1 0.0 0.0 0.0 100.0 Mayo Mayo General Hospital 5 4 5 13 4 0 0 0 0 31 16.1 12.9 16.1 41.9 12.9 0.0 0.0 0.0 0.0 100.0 Total 145 116 135 249 108 31 1 0 0 785 18.5 14.8 17.2 31.7 13.8 3.9 0.1 0.0 0.0 100.0 69
Irish Psychiatric Units and Hospitals Census 2006 70 Irish Psychiatric Units and Hospitals Census 2006
Table 5.8 Irish Psychiatric Units and Hospitals Census 2006. Psychiatric hospitals and length of stay. Numbers with percentages.
Under 1 1-< 2 2-< 4 1-< 3 3 months- 1-< 5 5-< 10 10-< 25 25 years week weeks weeks months < 1 year years years years and over Total Dublin North St Ita’s Hospital, Portrane 14 3 9 16 22 23 8 14 16 125 11.2 2.4 7.2 12.8 17.6 18.4 6.4 11.2 12.8 100.0 Dublin North Central St Vincent’s Hospital, Fairview 9 8 3 17 14 19 8 1 0 79 11.4 10.1 3.8 21.5 17.7 24.1 10.1 1.3 0.0 100.0 North West Dublin St Brendan’s Hospital, Dublin 6 5 6 22 19 27 14 10 2 111 5.4 4.5 5.4 19.8 17.1 24.3 12.6 9.0 1.8 100.0 Dublin South West and Dublin West St Loman’s Hospital, Dublin 1 1 0 3 3 11 1 2 0 22 4.5 4.5 0.0 13.6 13.6 50.0 4.5 9.1 0.0 100.0 Dun Laoghaire Cluain Mhuire Family Centre, Dublin 10 5 4 13 5 0 0 0 0 37 27.0 13.5 10.8 35.1 13.5 0.0 0.0 0.0 0.0 100.0 Wicklow Newcastle Hospital, Greystones 11 2 3 9 8 13 5 1 0 52 21.2 3.8 5.8 17.3 15.4 25.0 9.6 1.9 0.0 100.0 Laois/Offaly St Fintan’s Hospital, Portlaoise 1 0 0 1 7 6 6 7 3 31 3.2 0.0 0.0 3.2 22.6 19.4 19.4 22.6 9.7 100.0 Longford/Westmeath St Loman’s Hospital, Mullingar 9 8 5 9 21 35 21 19 26 153 5.9 5.2 3.3 5.9 13.7 22.9 13.7 12.4 17.0 100.0 Limerick St Joseph’s Hospital, Limerick 0 0 0 1 12 28 13 11 20 85 0.0 0.0 0.0 1.2 14.1 32.9 15.3 12.9 23.5 100.0 Louth St Brigid’s Hospital, Ardee 6 2 5 4 3 12 7 9 6 54 11.1 3.7 9.3 7.4 5.6 22.2 13.0 16.7 11.1 100.0 71
Irish Psychiatric Units and Hospitals Census 2006 70 Irish Psychiatric Units and Hospitals Census 2006
Table 5.8 Irish Psychiatric Units and Hospitals Census 2006. Psychiatric hospitals and length of stay. Numbers with percentages (continued). Under 1 1-< 2 2-< 4 1-< 3 3 months- 1-< 5 5-< 10 10-< 25 25 years week weeks weeks months < 1 year years years years and over Total Cavan/Monaghan St Davnet’s Hospital, Monaghan 0 0 1 2 5 7 4 4 12 35 0.0 0.0 2.9 5.7 14.3 20.0 11.4 11.4 34.3 100.0 Sligo/Leitrim Mental Health Service, Sligo 10 2 4 11 9 3 3 3 0 45 22.2 4.4 8.9 24.4 20.0 6.7 6.7 6.7 0.0 100.0 Donegal St Conal’s Hospital, Letterkenny 0 0 0 1 1 2 5 10 6 25 0.0 0.0 0.0 4.0 4.0 8.0 20.0 40.0 24.0 100.0 Carlow/Kilkenny St Canice’s Hospital, Kilkenny 0 2 0 0 6 22 12 3 7 52 0.0 3.8 0.0 0.0 11.5 42.3 23.1 5.8 13.5 100.0 St Dympna’s Hospital, Carlow 0 1 0 0 5 16 10 16 16 64 0.0 1.6 0.0 0.0 7.8 25.0 15.6 25.0 25.0 100.0 Tipperary St Luke’s Hospital, Clonmel 1 0 1 4 7 36 25 26 45 145 0.7 0.0 0.7 2.8 4.8 24.8 17.2 17.9 31.0 100.0 Waterford St Otteran’s Hospital, Waterford 0 1 2 4 13 40 20 16 11 107 0.0 0.9 1.9 3.7 12.1 37.4 18.7 15.0 10.3 100.0 Wexford St Senan’s Hospital, Enniscorthy 7 12 9 16 21 22 9 7 7 110 6.4 10.9 8.2 14.5 19.1 20.0 8.2 6.4 6.4 100.0 North Cork St Stephen’s Hospital, Cork 3 6 6 7 10 15 29 59 2 137 2.2 4.4 4.4 5.1 7.3 10.9 21.2 43.1 1.5 100.0 Kerry St Finan’s Hospital, Killarney 0 0 1 3 2 15 11 19 28 79 0.0 0.0 1.3 3.8 2.5 19.0 13.9 24.1 35.4 100.0 East Galway St Brigid’s Hospital, Ballinasloe 7 3 4 14 8 22 11 26 64 159 4.4 1.9 2.5 8.8 5.0 13.8 6.9 16.4 40.3 100.0 71
Irish Psychiatric Units and Hospitals Census 2006 72 Irish Psychiatric Units and Hospitals Census 2006
Table 5.8 Irish Psychiatric Units and Hospitals Census 2006. Psychiatric hospitals and length of stay. Numbers with percentages (continued).
Under 1 1-< 2 2-< 4 1-< 3 3 months- 1-< 5 5-< 10 10-< 25 25 years week weeks weeks months < 1 year years years years and over Total Mayo St Mary’s Hospital, Castlebar 0 0 0 0 4 26 9 4 5 48 0.0 0.0 0.0 0.0 8.3 54.2 18.8 8.3 10.4 100.0 Other services Central Mental Hospital, Dundrum 1 1 1 10 7 19 16 10 9 74 1.4 1.4 1.4 13.5 9.5 25.7 21.6 13.5 12.2 100.0 St Joseph’s Intellectual Disability Service 0 0 0 3 8 25 21 39 66 162 0.0 0.0 0.0 1.9 4.9 15.4 13.0 24.1 40.7 100.0 Carraig Mór, Cork 2 1 4 1 9 6 4 12 2 41 4.9 2.4 9.8 2.4 22.0 14.6 9.8 29.3 4.9 100.0 Total 98 63 68 171 229 450 272 328 353 2,032 4.8 3.1 3.3 8.4 11.3 22.1 13.4 16.1 17.4 100.0
Table 5.9 Irish Psychiatric Units and Hospitals Census 2006. Private hospitals. Length of stay. Numbers with percentages.
Under 1 1-< 2 2-< 4 1-< 3 3 months- 1-< 5 5-< 10 10-< 25 25 years week weeks weeks months < 1 year years years years and over Total Bloomfield Hospital, Dublin 0 0 0 0 17 11 4 3 0 35 0.0 0.0 0.0 0.0 48.6 31.4 11.4 8.6 0.0 100.0 Hampstead and Highfield Hospitals, Dublin 1 0 2 8 15 41 13 5 1 86 1.2 0.0 2.3 9.3 17.4 47.7 15.1 5.8 1.2 100.0 Kylemore Clinic, Dublin 0 0 0 1 10 9 9 4 1 34 0.0 0.0 0.0 2.9 29.4 26.5 26.5 11.8 2.9 100.0 Palmerstown House, Dublin 1 0 0 0 1 2 1 1 0 6 16.7 0.0 0.0 0.0 16.7 33.3 16.7 16.7 0.0 100.0 St John of God Hospital, Dublin 29 16 27 46 14 0 1 0 0 133 21.8 12.0 20.3 34.6 10.5 0.0 0.8 0.0 0.0 100.0 St Patrick’s Hospital, Dublin 56 40 75 93 10 4 0 0 0 278 20.1 14.4 27.0 33.5 3.6 1.4 0.0 0.0 0.0 100.0 Total 87 56 104 148 67 67 28 13 2 572 15.2 9.8 18.2 25.9 11.7 11.7 4.9 2.3 0.3 100.0 73
Irish Psychiatric Units and Hospitals Census 2006 72 Irish Psychiatric Units and Hospitals Census 2006 ‘Long-stay’ in-patientsaredefinedasthosecontinuouslyhospitalised(i.e.notdischarged)foroneyearorlonger. respectively madetothepsychiatric hospitals’in-patientpopulationsduringeachoftherelevant censusyears. Table 6.2 patients, itisinstructivetoexamine whatcontributionpersonsaged 65yearsandoverthose75 Since aconsiderableinfluence onthedeclineinnumbersoflong-staypatientshasbeen mortalityamong elderlyin- Table 6.1 overall havedeclinedintheperiod1971to2006;thistrendappliesequally ‘theoldlong-stay’andnewlong-stay’. Table 6.1showshowthenumbersoflong-stayin-patientsasaproportionsharplycontractingin-patientpopulation long-stay in-patientThe population 1971– proposition inthelightofpresenthospitalcensusandrecentactivity. by 2011long-staypatientsinin-patientcarewillhavebecomeaphenomenonofthepast.Itisappositetore-examinethis In arecentpublication,whichlookedatin-patientactivityandexaminedthisdecline,Walsh andDaly(2004)predictedthat advancing intotheoverfiveyearsgroupi.e.oldlong-stay. under oneyearofcontinuousin-patientcaretothecategoryoverandalsothose There hasbeenasharpdeclineinthenumberofpatientsbecoming‘newlong-stay’i.e.thosepassingfromcategory psychiatric hospitalsinIrelandcater, inthemain,foracuteillnessanddonotaspiretoprovidinglong-termcare. units. Therecommendationappliedtopsychiatrichospitalsinthepublicsectoronly;thisisbecausetwoacuteprivate should closeandthatlong-staypatientsundergorehabilitationinspecialised,community-based for Change One ofthecentralrecommendationsrecentpolicydocumentonfuturepsychiatriccareandservices, residences inrecentyearsandthesenowprovidemorethan3,000places. number ofpsychiatrichospitalsstillinoperation.Notwithstandingmanylong-stayin-patientshavemovedtocommunity patients, manyofwhomareelderlyandwereadmittedtohospitalyearsago,haveaggregatedinthedwindling With thegrowingemphasisonprovidingshort-termacutein-patientcareingeneralhospitalpsychiatricunits,long-stay has thereforebeenarapiddeclineinthenumberofhospitalisedpersonsandlong-stayin-patients. to thelackofspecialisedservicesforsuchpersons. Inrecentyearsmosttheseshortcomingshavebeenaddressed;there the psychiatrichospitalisationofmanyintellectuallydisabledpersonsandelderlywithuncomplicateddementiadue accommodation forrecoveringpatientsandthosewithresidualimpairments.Theproblemhasalsobeencompoundedby of rehabilitationandcommunity-basedcaretherehasbeen,inmanyinstances,thenon-availabilityalternativeresidential hospitalisation ratesofanycountry. Thereasonsforthenon-dischargeofpatientshavebeenmany;inadditiontolack of long-stayin-patientsinpublicpsychiatrichospitalswiththeresultthatIrelandhadonehighest A predominantfeatureofIrishpsychiatryhasbeentheaccumulation,throughnon-discharge,substantialnumbers between oneandfiveyears)the‘oldlong-stay’(i.e.thosehospitalisedwithoutdischargeforyearslonger). Traditionally, thiscategoryofpatientshasbeensubdividedintothe‘newlong-stay’(i.e.thosehospitalisedcontinuouslyfor 6.
1971 Year 2006 2001 1991 1981 the long-stay in-patientpopulation declineof The in-patients. Irish PsychiatricIrish UnitsandHospitals Census 1971– (ReportoftheExpertGrouponMentalHealthPolicy, 2006),wasthatallexistingpublicpsychiatrichospitals Numberswithpercentages. All in-patients All 16,661 13,984 3,389 4,321 8,207 Over 1year 10,502 12,860 1,545 2,316 5,646
2006. 2006 46 54 68 75 77 % New and old long-stay as a proportion of all New andoldlong-stay ofall asaproportion 1–5 years 1–5 1,366 2,413 3,219 548 778 16 18 16 17 19 % Over 5years 1,538 4,280 8,089 9,641 997
A Vision 29 36 52 58 58 % 73
Irish Psychiatric Units and Hospitals Census 2006 74 Irish Psychiatric Units and Hospitals Census 2006 The decreaseinnumbersbecomingnewlong-stayoverthe40yearperiod,1966–2006isclear. Ofthosewhobecamenew Activities ofIrishPsychiatricUnits andHospitalsforeachofthefiveyears2001–2005. Table 6.4showsthecombinednumbers ofdischargesanddeathsnewoldlong-staypatients –asrecordedinthe three quarters (76%), were resident in the psychiatric hospitals which still remained in operation on censuspatients night fell 2006. to 3,389 in 2006 and the number of long-stays decreased to 1,545. Of these long-stay patients,of discharges 1,174, orand more deaths than have outstripped the numbers of patients becoming long-stay. As a consequence, the number of in- deaths; the resulting ‘accumulation’ (to use the 19 Throughout that period, the numbers of patients in the long-stay category far outnumbered the numbers ofthe discharges period 1966-2006. and As can been seen in Table 6.1, there has been a considerable decline in the numbers of long-stay in-patients throughout the long-stay among in-patient population Attrition had risento250,ayearlyaverageof50. patients, i.e.ayearlyaverageof44,whileby2001-2006thenumberthosebecomingnewlongstayandaged65 over later fiveyearperiodof 60patients.Inthe1996–2001,thoseaged65andoveraccountedfor222newlong-stay year. Two hundredandninetyeightpatientsunder65becamenewlong-stayfrom2001to2006,ayearlyaverageforthis long-stay duringtheperiod1996to2001,some556personswereagedlessthan65years,anaverageof111patientsper preceding eachcensus yearthe yearly and average. Table Psychiatric 6.3 Irish UnitsandHospitals Census 1971– for eachfiveyearinterval,theyearlyaverage. number ofpatientsenteringtheonetofiveyear(newlong-stay)categoryinyearsprecedingeachcensusand, continuous hospitalisation’,yearonfrom1971onwards. Table 6.3isinformativeinthisregardasitshowsthetotal moved fromthecategoryof‘lessthanoneyearcontinuoushospitalisation’to‘more The nextquestiontobeaddressedconcernstheevolutionoflong-stayin-patientsinperiod19712006–howmany years andover. elderlyin-patients. Numberswithpercentagesin-patients andofall ofall andasaproportion Table Psychiatric 6.2 Irish UnitsandHospitals Census 1971– elderly hasincreasedfrom41%to53%19712006. all long-stayin-patientsin2006. Theproportionofpatientsthe75andoveragegroupasa indicates thatin-patientsaged65yearsandoveraccountedforjustunderhalf those75aquarterof resident in Irish psychiatric hospitals totalled 21,000, over 80% of whom were long-stay.
2001–2006 1996–2001 1986–1991 1976–1981 1966–1971 2006 2001 1991 1981 1971 Year Year All long- All 10,502 12,860 5,646 1,545 2,316
stay This decline is a comparatively recent phenomenon in the history of asylum/mental hospital care.
Long-stay 720 1,198 2,641 4,087 4,243 65 years andover in-patients % of all % ofall th century term) reached its peak in 1958 when the number 21 28 32 29 25 Cumulative new long-stay
long-stay 2006. 2006. Long-stay in-patients aged 65years andover and 75 % of 47 52 47 39 33 Numbersbecoming new long-staythe five in years
Long-stay 1,366 2,413 548 778 3,219 380 620 1,248 1,776 1,724 in-patients
Since 75 years andover % of all % ofall
1958, however, the numbers 11 14 15 13 10 Yearly average new long-stay
long-stay % of
of patients 25 17 27 22 13
% long-stay
elderly
110 156 273 482 643 53 52 32 43 41
75
Irish Psychiatric Units and Hospitals Census 2006 74 Irish Psychiatric Units and Hospitals Census 2006 Table Numbersofdischarges anddeaths combined oflong-stay 6.4 patients 2001– remaining public psychiatric hospitals, most of which are greatly diminished in size and in the number ofGroup onMentalHealthPolicy, patients 2006)isto provide they cater The DepartmentofHealthand Children’s morerecentpolicyasdocumented in units should be established in general hospitals for the treatment of acute psychiatricpsychiatric illness hospital. (Department of Health, 1966) At the time when the first psychiatric hospital census was carried out in 1963, all in-patients were resident Long-stayin in-patients inpsychiatric hospitals a traditional 49 long-stay persons aged 75 and over were discharged age increases so too does the likelihood of leaving long-term inpatient care by death rather than by discharge.As Table For example 6.6 demonstrates, while discharges accounted for 68% of the decrease in the numbers of long-stay in-patients. However, as Table 2001– 6.6 Dischargesthe period anddeaths oflong-stay ages in-patients during ofall the overallnumberofdeathsascanbeseeninTable 6.6. accounted for60%ofdeathsanddischarges. Within thelong-staypopulation, theoverallnumberofdischargesexceeded patients agedover65yearscomparedtothoseyounger. Amongtheelderly(those65andover),thoseaged75over Over thefive-yearperiod2001-2005,therewasaslightexcessinnumbersofdischargesanddeathslong-stayin- Table 6.5 Ages ofdischarges anddeaths combined oflong-stay in-patients 2001–005. Data ontheagesofdischarged(includingdeaths)long-stayin-patientsarepresentedinTable 6.5.
a 2001–2005 2005 2004 2003 2002 2001 Year 2001–2005 2005 2004 2003 2002 2001 Year 2001–2005 2005 2004 2003 2002 2001 Five dischargeshadunspecifiedages. Year
Three years later the Report of the Commission of Enquiry on Mental Illness recommended that psychiatric Under 65years 220 193 194 326 262 1,195 New long-stay Discharges all
from inpatient care in 2005, 79 (62%) died in hospital. acutecareingeneralhospital psychiatric unitsandtoclosethe 235 217 272 325 239 1,288 1,690 277 265 299 477 374 and over 65 years 210 222 268 319 258 1,277
Old long-stay A Vision forChange 65–74 65–74 years 516 139 100 82 97 98 Deaths 2005.
200 198 190 320 281 1,189 782 158 150 163 168 146 2005 and over 75 years (ReportoftheExpert 761 128 125 170 180 158
All long-stay All
435 435 415 462 645 520 2,477 415 462 645 520 2,477 2,477 415 462 645 520 Both 435 All a 75
Irish Psychiatric Units and Hospitals Census 2006 76 Irish Psychiatric Units and Hospitals Census 2006 hospitals (as distinctfromgeneralhospitalunitsandexcludingprivatepsychiatrichospitals,TheCentralMentalHospital, However evenbeforethedeclarationofthisnewerpolicyobjective numbersin-patientsremaininginpsychiatric at 2005rates,400-500in-patientswillbecomenewlong-stay. However, itcouldbearguedthatdueto therateatwhich Irish publicpsychiatrichospitalswillhaveleftinfouryearstime i.e.bytheendof2010. From2006to2010,however, On thebasisofaconservativelyestimated350discharges/deaths perannum,thecurrent1,381long-stay in-patientsin rehabilitation facilities. 6 Table 6.7 Table 6.7belowchartsdischargesfrompubliclong-staycarein2001and2005. public in-patientsrecordedfor2006. number ofpublicpsychiatrichospitallong-stayin-patients.Thisthereforebringsto1,381thetotal plus anadditional54long-stayin-patientsintheCentralMentalHospital,Dundrum,shouldbedeductedfromtotal persons becominglong-stay. Itshouldbenotedhoweverthatthefiguresof110long-stayin-patientsinprivatehospitals, The smallerproportionofnewlong-staypatientsreportedfor2006isadirectconsequencethenumbers 1,174 werelong-stayand400newlong-stay. totalled 3,125ofwhom2,156werelong-stayand1,187newlong-stay. By2006thenumberhadfallento1,755ofwhom St. Joseph’s IntellectualDisabilityServiceatSt.Ita’s andCarraigMór)hadfallensignificantly. In2001,for example,they long-stay for, most ofwhomarelong-stay. Henceforthpersonswithpersistingillness,whoinyearsgonebywouldhavebecome and shouldbeappropriatelydischarged withouttoomuchdifficulty. smaller numbersfromthepreceding years.Thenumbersinanygivenpsychiatrichospital from thispoolwillbequitesmall long-stay shouldhaveleftbytheendof2010.Howeverthere willremainasmallresidueaccumulatedduringthatyearwith each year. Sincethisnumbercomfortablyexceedsthosebecomingnew long-stay, maximally 110annually, theremaining experience suggeststhataminimumof150newlong-stayin-patients willbedischargedfrompublicpsychiatrichospitals patients joiningthiscategoryhavebeendeclininginrecentyears, numberscouldbesubstantiallyfewerthanthis.Recent number ofnewlong-staypatientsaccruingfrom2001to2005 was110. long-stay. In 2005, forexample,435patientsleftlong-staycare,390fromthepublicsector;incontrast,yearlyaverage In recentyearsthenumbersofin-patientsleavinglong-staycategoryhavesubstantiallyexceededthosebecomingnew and thegreatlydecreasednumbersofpatientsbecoming long-stay. old long-stay)declinedsharplybetween1966and2006becauseof thecumulativeconsequencesdischargesdeaths The principallessonstobedrawnfromallofthisarerelativelysimple. numberslong-stayin-patients(bothnewand Conclusionsthe future and although it is likely that the length of stay of their acute patients could be further shortened (Keogh Clearly, psychiatric units have not accumulated many long-stay in-patients and have fulfilled theirTable acute role 6.7 reasonably shows the well, contrasting figures of discharges for public psychiatric hospitals and psychiatric units in general hospitals.
2001 Year 2005 hospital. Some psychiatrichospitalsstillprovide foracuteillnessmostlyinseparateadmissionunitswhicharefreestandingand notpartofthefabricoriginal
6 Discharges from long-stay care in public psychiatric hospitals and general hospital psychiatric units inpsychiatrichospitals,willberehabilitatedandtheirrecoverypromotedspecialisedcommunity-based Psychiatric hospital Psychiatric hospital Psychiatric Unit Psychiatric Unit Hospital type Hospital New Long-stay 188 159 29 48 Old long-stay 0 0 183 265 et al , 1999). 2 001 and All long-stay All 2 453 342 005. 48 29
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Irish Psychiatric Units and Hospitals Census 2006 76 Irish Psychiatric Units and Hospitals Census 2006 bringing toanendalmosttwocenturiesofinstitutionalcarethementallyill. that noorveryfewlong-staypatientswill remaininpsychiatrichospitalsbytheendof2010islikelytobefulfilledthus persist andevenaccelerateoverthenextfiveyears. InlightofthisexperiencepredictionWalsh andDaly(2004) characterised byincreaseddischargesfromandreducedentrantstolong-stayin-patientcareappearsstablelikely While thefuturefunctioningofahealthserviceisalwaysdifficulttopredictpatternin-patientcareoutlinedhereand 77
Irish Psychiatric Units and Hospitals Census 2006 78 Irish Psychiatric Units and Hospitals Census 2006 Description and DiagnosticGuidelines World HealthOrganisation(WHO) (1992) Dublin: HealthResearchBoard. Walsh D&DalyA(2004) Walsh D(1971) Psichuatria Sociale. Ruud T, Lindefors N, Lindhardt A (2006) Current issues in Scandinavian acute psychiatric wards. Epidemiologia E Report oftheExpertGrouponMentalHealthPolicy(2006) O’Hare A & Walsh D (1983) O’Hare A & Walsh D (1974) Moran R,&Walsh D(1992) Book One Mental HealthCommission(2006) Services Mental HealthCommission(2005) Beds intheEasternHealthBoardRegion Keogh F, RocheA,Walsh D(1999)“ ISD OnlineScottishHealthStatisticshttp://www.isdscotland.org/isd/files/data7.xls Department ofHealthandChildren(2001) Department ofHealth(1966) Department ofHealth(1945) Daly A&Walsh D(2002) Daly A & Walsh D (2006) health hospitalsandfacilitiesinEnglandWales Commission forHealthcareAuditandInspection(2005) Central StatisticsOffice(2003c) Central StatisticsOffice(2003b) Central StatisticsOffice(2003a) Central StatisticsOffice(2006)Census2006PreliminaryReport.Dublin:StationeryOffice. References . Dublin. . Dublin. The 1963IrishPsychiatricHospitalCensus An International Journal for Epidemiology and Psychiatric Sciences Activities of Irish Psychiatric Units and Hospitals and Units 2005 Mental IllnessinIreland1750-2002. ReflectionsontheRiseandFallofInstitutionalCare Irish PsychiatricHospitalsandUnitsCensus2001 The IrishPsychiatrichospitalsandUnitsCensus1991 The Irish Psychiatric Hospitals and Units Census 1981 The Irish Psychiatric Hospitals and Units Census 1971 Commission ofInquiryonMentalIllness1966Report Mental Treatment Act Census 2002.Volume 4.PrincipalSocio-economicResults Census 2002.Volume 1.PopulationClassifiedbyArea Census 2002.Volume 2.AgesandMaritalStatus Annual ReportincludingtheofInspectorMentalHealthServices2005. Annual Report2004includingtheofInspectorMentalHealth We havenoBeds….”AnenquiryintotheavailabilityanduseofAcutePsychiatric . Geneva:WHO. . Dublin:HealthResearchBoard. Mental HealthAct2001 The ICD-10Classificationof Mental andBehaviouralDisorders.Clinical . London. . Dublin:StationeryOffice. Count Mein.Resultsofanationalcensusinpatientsinmental . Dublin:Medico-SocialResearchBoard. A Vision forChange . Dublin:StationeryOffice. . Dublin:HealthResearchBoard. . Dublin:StationeryOffice. . Dublin:StationeryOffice. . Dublin: Medico-Social Research Board. . Dublin: Medico-Social Research Board. . Dublin:HealthResearchBoard. 15 (2): April-June 2006, pp 99-103. . Dublin:StationeryOffice. . Dublin:StationeryOffice. . Dublin: Health Research Board. . Dublin:StationeryOffice.
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Irish Psychiatric Units and Hospitals Census 2006 78 Irish Psychiatric Units and Hospitals Census 2006 Appendix1: form Sample data collection 79
Irish Psychiatric Units and Hospitals Census 2006 80 Irish Psychiatric Units and Hospitals Census 2006 Dublin: HealthResearchBoard. Walsh D&DalyA(2004) Psychiatric DayHospitalsandCentres:AStudyinTwo HealthBoards. Hickey T, MoranR&Walsh D(2003) Psychiatric BedsintheEasternHealthBoardregion. Keogh F, RocheA&Walsh D(1999) Research Board. O’Hare A&Walsh D(1987) Other publications: Daly A&Walsh D(2002) Moran R&Walsh D(1992) Medico-Social ResearchBoard. O’Hare A&Walsh D(1983) Walsh D(1971) Psychiatric in-patientCensusPublications: Psychiatric ReportingSystemBulletins. Activities ofIrishPsychiatricHospitalsandUnits/Services1965–2005. Activities ofIrishPsychiatricServicespublications: Appendix 2: Mental Health Research DivisionPublications The 1963IrishPsychiatricHospitalCensus. Mental IllnessinIreland1750-2002.ReflectionsontheRiseandFallofInstitutionalCare. Irish PsychiatricHospitalsandUnitsCensus2001. The ThreeCountyandSt.Loman’s PsychiatricCaseRegisters,1987. The IrishPsychiatricHospitalsandUnitsCensus1991. The IrishPsychiatricHospitalsandUnitsCensus1981. “We HaveNoBeds….”AnenquiryintotheavailabilityanduseofAcute Dublin:HealthResearchBoard. Psychiatric DayCare–AnUnderusedOption?Thepurposesandfunctionsof Dublin:HealthResearchBoard. Dublin:Medico-SocialResearchBoard. Dublin:Medico-SocialResearchBoard/HRB. Dublin:HealthResearchBoard. Dublin:HealthResearchBoard. Dublin:HealthResearchBoard. Dublin: Dublin:Medico-Social
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Irish Psychiatric Units and Hospitals Census 2006 Irish Psychiatric Units and Hospitals Census 2006 Irish PsychiatricIrish Units and Hospitals Census 2006 www.hrb.ie
Antoinette Daly and Dermot Walsh