title: Custody, care and country of origin: demographic and diagnostic admission statistics at an inner-city adult psychiatry unit.
abstract: Involuntary detention is a feature of psychiatric care in many countries. We previously reported an involuntary admission rate of 67.7 per 100,000 population per year in inner-city Dublin (January 2008-December 2010), which was higher than Ireland's national rate (38.5). We also found that the proportion of admissions that was involuntary was higher among individuals born outside Ireland (33.9%) compared to those from Ireland (12.0%), apparently owing to increased diagnoses of schizophrenia in the former group. In the present study (January 2011-June 2013) we again found that the proportion of admissions that was involuntary was higher among individuals from outside Ireland (32.5%) compared to individuals from Ireland (9.9%) (p<0.001), but this is primarily attributable to a lower rate of voluntary admission among individuals born outside Ireland (206.1 voluntary admissions per 100,000 population per year; deprivation-adjusted rate: 158.5) compared to individuals from Ireland (775.1; deprivation-adjusted rate: 596.2). Overall, admission rates in our deprived, inner-city catchment area remain higher than national rates and this may be attributable to differential effects of Ireland's recent economic problems on different areas within Ireland. The relatively low rate of voluntary admission among individuals born outside Ireland may be attributable to different patterns of help-seeking which mental health services in Ireland need to take into account in future service-planning. Other jurisdictions could also usefully focus attention not just on rates on involuntary admission among individuals born elsewhere, but also rates of voluntary admission which may provide useful insights for service-planning and delivery.
authors: Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 62/63 Eccles Street, Dublin 7, Ireland. Electronic address: brendankelly35@gmail.com.
authors: Brendan D
authors: BD
authors: Kelly
authors: Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 62/63 Eccles Street, Dublin 7, Ireland. Electronic address: afam_unth2000@yahoo.com.
authors: Afam
authors: A
authors: Emechebe
authors: Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 62/63 Eccles Street, Dublin 7, Ireland. Electronic address: chike_anamdi@yahoo.com.
authors: Chike
authors: C
authors: Anamdi
authors: Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 62/63 Eccles Street, Dublin 7, Ireland. Electronic address: duffyrm@gmail.com.
authors: Richard
authors: R
authors: Duffy
authors: School of Medicine, Clinical Sciences Institute, National University of Ireland Galway, Newcastle Road, Galway, Ireland. Electronic address: N.MURPHY24@nuigalway.ie.
authors: Niamh
authors: N
authors: Murphy
authors: Department of Adult Psychiatry, University College Dublin, Mater Misericordiae University Hospital, 62/63 Eccles Street, Dublin 7, Ireland. Electronic address: catherine.rock@ucdconnect.ie.
authors: Catherine
authors: C
authors: Rock
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D010343:Patient Admission / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D011567:Psychiatric Department, Hospital / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Commitment of mentally ill; Ethnopsychology; Formal social control; Legislation and jurisprudence; Mental disorders; Psychiatric hospitals