A national audit of new long-stay psychiatric patients. II: Impact on services.
BACKGROUND
This second report of a national audit of new long-stay (NLS) psychiatric patients describes the services caring for the patients and the reasons why patients were still in hospital.


METHODS
Data analyses addressed the prevalence of NLS patients, the residential resources available to services, the distributions of patients within services, clinicians' views as to the appropriateness of current placement and the reasons for any inappropriate placements.


RESULTS
The average point prevalence was 6.1 per 100,000 population; it was significantly lower in England and Wales (5.6, s.d. = 3.2) than in Scotland and Northern Ireland (10.7, s.d. = 6.4, ANOVA F ratio = 10.9, P < 0.01). The estimated rate of accumulation was 1.3 per 100,000 population per year. Many English services had very few non-acute psychiatric beds and 31% of English NLS patients, despite their protracted lengths of stay, were housed on acute wards. Assessors thought that 61% of patients would be better placed in a non-hospital setting; 47% were thought to require a community-based residential setting, and of these over one-half were still in hospital because no suitable community placement was available.


CONCLUSIONS
Many NLS patients remain in hospital because their residential needs are not met by existing community provision.
Research Unit, Royal College of Psychiatrists, London.
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Lelliott
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Wing
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data; D006300:Health Services Misuse / Q000706:statistics & numerical data*; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008297:Male; D008485:Medical Audit / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation; D008875:Middle Aged; D010348:Patient Care Team / Q000706:statistics & numerical data; D012040:Regional Health Planning / Q000706:statistics & numerical data; D012112:Residential Facilities / Q000706:statistics & numerical data; D013222:State Medicine / Q000706:statistics & numerical data; D006113:United Kingdom; D014600:Utilization Review / Q000706:statistics & numerical data*