November 13, 2007

Carl O'Brien, Social Affairs Correspondent

A new study has revealed that high numbers of patients with mental illness are being readmitted into psychiatric hospitals, raising serious questions over the quality of community-based care.

The Health Research Board (HRB) study found that more than one in three patients admitted to psychiatric hospitals in 2001 were readmitted at least once during the following five years. Almost one in 10 was re-admitted four or more times.

The findings clearly indicate that the expansion of community based services in recent years has not reduced the need for in-patient treatment for people with mental illness. The majority of patients readmitted were experiencing an enduring illness such as clinical depression or schizophrenia, the study found.

During the 2001-2005 period, one in three patients was readmitted for depression, one fifth readmitted for alcohol disorders and one in eight was readmitted for schizophrenia.

Antoinette Daly, researcher at the HRB, said: "We also discovered that people readmitted were more likely to be female, young, unmarried, to have more than one psychiatric illness and be living in a county with a large urban centre."

Researchers also found that in facilities where there were more medical staff, patients had a shorter length of stay and fewer were readmitted or became frequent users.

"This important finding requires further research," Ms Daly said, "especially as the overall results show that patients who remain in hospital for a longer time when they are first admitted are more likely to be re-admitted than those who have a shorter stay at first admission."

She said the high readmission rates indicated the need to examine the extent, quality and operation of community services.

"This is particularly important in relation to alcohol disorders, considering that the policy for a number of years has been that people with alcohol disorders should actually be cared for in community settings," she said.

The findings echo concerns expressed over the quality of mental healthcare in the community by the Inspector of Mental Health Services earlier this year.

In her report, Dr Susan Finnerty said community-based treatment in most parts of the Republic was hampered by a lack of staff, poor management and resource shortages.

She said it was not good enough to condemn old mental health practices while not giving health professionals the resources to provide proper alternatives in the community.

"In-patient units will continue to be the first line treatment locations, long stay wards will not close and there will be little or no access to alternatives to medication if community mental health and other multidisciplinary teams are not resourced," she said.