Social deprivation and psychiatric service use for different diagnostic groups (original) (raw)
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The Journal of Emergency Medicine, 2016
Background: Acute involuntary psychiatric admissions (AIPA) tend to be applied more often in urban areas. Objective: The current study aims to describe AIPA prevalence differences between the subdistricts in an urban area, and to identify which district characteristics are associated with a higher AIPA district density. Methods: Information was collected on consecutive AIPAs over a 64-month period (2005-2010) in 49 subdistricts in and around the city of Utrecht, the Netherlands, including 1098 AIPAs. District characteristics included several demographic and economical factors and health care characteristics such as number of sheltered living facilities. Results: The AIPA density (mean 4.4/10,000 inhabitants/ y) was four to five times higher in the most urbanized subdistrict (around 12) compared to the suburban subdistricts (2.5-3). On the district level, the main correlates with AIPA density per district were unemployment rate and small household size. Other correlates were percentage of non-Western immigrants and number of facilities of sheltered living. Conclusions: The considerable AIPA density variation between subdistricts in this urban environment reflects that people who are prone to psychiatric admissions live in economically less prosperous environments. Impaired social networks and economic concerns may also contribute to an environment representing social defeat, increased demoralization, or social fragmentation.
Health & Place, 2006
We report on comparative analyses of small area variation in rates of acute hospital admissions for psychiatric conditions in Greater London around the year 1998 and in New York City (NYC) in 2000. Based on a theoretical model of the factors likely to influence psychiatric admission rates, and using data from the most recent population censuses and other sources, we examine the association with area indicators designed to measure access to hospital beds, socio-economic deprivation, social fragmentation and ethnic/racial composition. We report results on admissions for men and women aged 15-64 for all psychiatric conditions (excluding self-harm), drug-related substance abuse/ addiction, schizophrenia and affective disorders. The units of analysis in NYC were 165 five-digit Zip Code Areas and, in London, 760 electoral wards as defined in 1998. The analysis controls for age and sex composition and, as a proxy for access to care, spatial proximity to hospitals with psychiatric beds. Poisson regression modeling incorporating random effects was used to control for both overdispersion in the counts of admissions and for the effects of spatial autocorrelation. The results for NYC and London showed that local admission rates for all types of condition were positively and significantly associated with deprivation and the association is independent of demographic composition or 'access' to beds. In NYC, social fragmentation showed a significant association with admissions due to affective disorders and schizophrenia, and for drug dependency among females. Racial minority concentration was significantly and positively associated with admissions for schizophrenia. In London, social fragmentation was associated positively with admissions for men and women due to schizophrenia and affective disorders. The variable measuring racial/ethnic minority concentration for London wards showed a negative association with admission rates for drug dependency and for affective disorders. We discuss the interpretation of these results and the issues they raise in terms of the potential and limitations of international comparison. r
Psychiatric Services, 2008
Objective: This study examined the association between socioeconomic deprivation and extended hospitalization in severe mental disorder, after taking account of confounding variables. Methods: A representative sample of 660 inpatients from South Auckland, New Zealand, was followed for two years from their index admission. Additional data were collected during the index admission for a subsample of 291 patients. Results: Greater levels of socioeconomic deprivation in the inpatient's neighborhood of residence was associated with extended hospitalization after adjustment for demographic factors and primary diagnosis but not after adjustment for comorbid diagnosis, chronicity, function, and severity. Most extended hospitalizations were related to poor illness recovery. Conclusions: People from more deprived areas are likely to need longer psychiatric admissions, mostly because of the asso-M Me el la an ni ie e A Am mn na a A Ab ba as s, , M M. .D D. . J Ja an ne e V Va an nd de er rp py yl l, , P Ph h.
SOCIODEMOGRAPHIC AND DIAGNOSTIC CHARACTERISTICS OF PSYCHIATRIC PATIENTS IN A GENERAL HOSPITAL
The sociodemographic, clinical characterestics and referral status of psychiatric patients in the outpatient department of a private teaching hospital over a period of 6 months were studied. The paper also compares the data with that of some other Indian studies and an Ethiopian study. Aim: To analyze the sociodemographic, diagnostic & referral status of patients attending psychiatric outpatient department. Results: The findings suggest that psychiatric morbidity is almost same in different centers and across in different times. The problems of mental illness are same all over the world has been highlighted in this study.
Social class, underprivileged areas and psychiatric disorder in the city of Stoke-on-Trent
Journal of Advanced Nursing, 1986
A survey of psychiatric disorder, bused on hospital inpatients records, was conducted in ihe City of Stoke-on-Trent, England for the year 1983. This was used to test ihe hypothesis that areas of lower social class and greatest underprivilege would display higher rates of inpatient admissions for psychiatric disorder than the more privileged areas of the city. The results confirmed a significant positive correlation between extent of underprivilege of an area and rates of inpatient admissions. The link between lower social class and mental disorder was not directly demonstrated.
Poverty, poor services, and compulsory psychiatric admission in England
Social Psychiatry and Psychiatric Epidemiology, 2002
Background Compulsory admission is a central feature of psychiatric systems internationally but the factors determining its use within different legal systems are not understood. Numbers of compulsory psychiatric admissions vary widely between areas in England. We examined the hypothesis that variation in rates of detention is related to social deprivation and also to the functioning of local mental health services. Methods Rates of detention under sections 2 and 3 of the Mental Health Act (1983) in 1998/9 were obtained in 34 mental health sectors in eight Trusts in England. Measures of socioeconomic deprivation and measures of service function were used to conduct an ecological analysis. Results Compulsory admission is associated with measures of deprivation but there is unexplained variation. The range in rates is higher than allowed for by the resource allocation formula. Some indicators of service quality are independently associated with rates of detention. Conclusions Variation in detention rates and its relation to service function need further explanation if the use of compulsion is to be reduced.
The British journal of psychiatry : the journal of mental science, 2016
Individual variables and area-level variables have been identified as explaining much of the variance in rates of compulsory in-patient treatment. To describe rates of voluntary and compulsory psychiatric in-patient treatment in rural and urban settings in England, and to explore the associations with age, ethnicity and deprivation. Secondary analysis of 2010/11 data from the Mental Health Minimum Dataset. Areas with higher levels of deprivation had increased rates of in-patient treatment. Areas with high proportions of adults aged 20-39 years had the highest rates of compulsory in-patient treatment as well as the lowest rates of voluntary in-patient treatment. Urban settings had higher rates of compulsory in-patient treatment and ethnic density was associated with compulsory treatment in these areas. After adjusting for age, deprivation and urban/rural setting, the association between ethnicity and compulsory treatment was not statistically significant. Age structure of the adult p...