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The impact of an expanding community mental health service on patterns of bed usage: evaluation of a four-year period of implementation

Published online by Cambridge University Press:  09 July 2009

H. Häfner  and
J. Klug
H. Häfner*
Affiliation:
Zentralinstitut für Seelische Gesundheit, Mannheim, West Germany
J. Klug
Affiliation:
Zentralinstitut für Seelische Gesundheit, Mannheim, West Germany
*
1Address for correspondence: Prof. Dr H. Häfner, Zentralinstitut für Seelische Gesundheit, 6800 Mannheim 1, J5, Postfach 5970, West Germany.
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Synopsis

In the city of Mannheim the introduction of an extensive community mental health service has been shown, by means of case-register data over 4½ years, to have led to a considerable increase in utilization, mainly at the out-patient level of care. The rates of admission to hospital increased very little. Due to the simultaneous decline in long-term bed occupancy, the overall need for psychiatric beds remained stable at a rate of about 1·2/1000, a rate which is very low by international standards.

The sharp decline in the ‘old’ long-stay population was followed by a smaller increase in ‘new’ long-stay patients which it has not been possible to prevent. These patients are, however, admitted for a long-term stay significantly later than formerly, and their diagnostic composition has changed significantly.

The increase in the bed requirements for short- and medium-term stay patients resulted from different sources: an increasing morbidity in some groups of disorders, the rising utilization in case of emergencies and severe crises, and the transfer of long-stay patients to alternative care services. The level of these needs was very similar in Mannheim, Salford, Samsø and Camberwell, whereas the rates for long-term beds still show clear national differences.

Type
Research Article
Information
Psychological Medicine , Volume 12 , Issue 1 , February 1982 , pp. 177 - 190
Copyright
Copyright © Cambridge University Press 1982

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