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Inner London Collaborative Audit of Admission in Two Health Districts

III: Reasons for Acute Admission to Psychiatric Wards

Published online by Cambridge University Press:  02 January 2018

C. B. Flannigan ,
G. R. Glover ,
J. K. Wing ,
S. W. Lewis ,
P. E. Bebbington  and
S. T. Feeney
C. B. Flannigan
Affiliation:
Royal College of Psychiatrists' Research Unit, London
G. R. Glover
Affiliation:
Royal College of Psychiatrists' Research Unit, London
J. K. Wing*
Affiliation:
Royal College of Psychiatrists' Research Unit, London
S. W. Lewis
Affiliation:
Royal College of Psychiatrists' Research Unit, London
P. E. Bebbington
Affiliation:
Royal College of Psychiatrists' Research Unit, London
S. T. Feeney
Affiliation:
Royal College of Psychiatrists' Research Unit, London
*
Professor John Wing, Royal College of Psychiatrists' Research Unit, 11 Grosvenor Crescent, London SW1X 7EE
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Abstract

Background

In this series, rates of admission and daily bed use in south Southwark were 30% higher than in Hammersmith & Fulham, principally because of a higher rate of admission for affective disorders. Factors associated with compulsory admission did not differ between the districts. This final paper examines the severity of symptoms, the reasons given for admission and factors relevant to the judgement to admit, in order to test the hypothesis that more resources mean better service.

Method

Sampling and data collection methods were described in the first paper.

Results

In both districts, major reasons for admission were self-neglect and risk of self-harm, poor adaptive functioning, and poor acceptance of medication. In south Southwark, a group of patients had affective disorders and less severe symptoms but a stated risk of suicide. Rates for, and severity of, schizophrenia were similar in the two districts. Social and preventive reasons for admission were given more frequently in south Southwark, where patients had more often been in contact with services before admission. Staff there, but not in Hammersmith & Fulham, suggested that many could have benefited from alternative forms of residential care.

Conclusions

A ‘buffer’ of hospital beds in south Southwark may have allowed a more acceptable service, particularly for affective disorders. The possibility that this buffer could be replaced by a wider range of residential accommodation, including hostels away from the District General Hospital, is discussed. Ten recommendations are listed.

Type
Papers
Information
The British Journal of Psychiatry , Volume 165 , Issue 6 , December 1994 , pp. 750 - 759
Copyright
Copyright © Royal College of Psychiatrists, 1994 

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