Large public psychiatric hospitals will be ready to close within three years due to a major reduction in the number of admissions, new research shows. The move would bring an end to almost 200 years of institutional care for the mentally ill.
A new census of psychiatric hospitals conducted in March this year shows the number of people resident in psychiatric units and hospitals has fallen by 83 per cent from almost 20,000 in 1963 to about 3,400 last year.
The decline is due mainly to an increased focus on providing care in the community, the introduction of more narrowly defined admission rules and the development of psychiatric units attached to general hospitals.
The closure of the older psychiatric institutions would be in line with the Government's plans for the mental health service, although its policy document suggests the process could take up to seven years to complete.
The Government has pledged to ringfence any funds from the sale of psychiatric hospitals or land and reinvest them in the mental health service.
The report, the Irish Psychiatric Units and Hospitals Census (2006), published by the Health Research Board (HRB), also shows that 22 per cent of all inpatients were detained against their will.
This figure is considered high by mental health campaigners, although it does not take into account changes in admissions procedures introduced since November which are likely to have led to a reduction in involuntary admissions.
The rates for involuntary admissions vary significantly in different parts of the country. It was highest in the HSE South (36 per 100,000 population) and lowest is the Dublin Mid-Leinster region (20 per 100,000).
Hospitalisation rates for all psychiatric problems were also highest in the HSE South, while Dublin Mid-Leinster and the West had the lowest.
Overall, the report says, psychiatric hospitalisation rates in Ireland were similar to rates prevailing elsewhere in western Europe. The most common diagnosis for patients was schizophrenia (33 per cent), followed by a depressive disorder (15 per cent), a mania (8 per cent) and an intellectual disability or related problem (7 per cent).
Almost half of patients included in the census had been in a psychiatric hospital for one or more years, while 29 per cent had been hospitalised for five years or more. Of all age groups, the 75 and over group had the highest rate of hospitalisation, followed by those aged from 65 to 74.
There were also major differences in the marital status of residents in psychiatric hospitals. Two-thirds of patients on census night were single, 18 per cent were married, 7 per cent were widowed and 1 per cent was divorced.
Overall, hospitalisation rates were six times higher for single males compared to married males. Large psychiatric hospitals accounted for most patients (52 per cent), followed by general acute hospitals (23 per cent), private hospitals (17 per cent) and other locations.
Psychiatric inpatient numbers
1963: 19,801 1970: 16,403
1975: 14,967 1980: 13,342
1985: 12,097 1990: 7,334
1995: 5,327 2000: 4,230
2006: 3,389
* Source: Irish Psychiatric Units and Hospitals Census (2006), published by the Health Research Board (HRB)
