Rates of voluntary and compulsory psychiatric in-patient treatment in England: an ecological study investigating associations with deprivation and demographics.
Individual variables and area-level variables have been identified as explaining much of the variance in rates of compulsory in-patient treatment.



To describe rates of voluntary and compulsory psychiatric in-patient treatment in rural and urban settings in England, and to explore the associations with age, ethnicity and deprivation.



Secondary analysis of 2010/11 data from the Mental Health Minimum Dataset.



Areas with higher levels of deprivation had increased rates of in-patient treatment. Areas with high proportions of adults aged 20-39 years had the highest rates of compulsory in-patient treatment as well as the lowest rates of voluntary in-patient treatment. Urban settings had higher rates of compulsory in-patient treatment and ethnic density was associated with compulsory treatment in these areas. After adjusting for age, deprivation and urban/rural setting, the association between ethnicity and compulsory treatment was not statistically significant.



Age structure of the adult population and ethnic density along with higher levels of deprivation can account for the markedly higher rates of compulsory in-patient treatment in urban areas.
Patrick Keown, MRCPsych, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Orla McBride, PhD, School of Psychology, University of Ulster, County Londonderry, Ulster; Liz Twigg, PhD, Department of Geography, University of Portsmouth, Portsmouth; David Crepaz-Keay, DProf, Mental Health Foundation, London; Eva Cyhlarova, DPhil, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford; Helen Parsons, PhD, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry; Jan Scott, MD, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Kamaldeep Bhui, MD, Centre for Psychiatry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London; Scott Weich, MD, Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK patrick.keown@newcastle.ac.uk.
Patrick
P
Keown
Patrick Keown, MRCPsych, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Orla McBride, PhD, School of Psychology, University of Ulster, County Londonderry, Ulster; Liz Twigg, PhD, Department of Geography, University of Portsmouth, Portsmouth; David Crepaz-Keay, DProf, Mental Health Foundation, London; Eva Cyhlarova, DPhil, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford; Helen Parsons, PhD, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry; Jan Scott, MD, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Kamaldeep Bhui, MD, Centre for Psychiatry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London; Scott Weich, MD, Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
Orla
O
McBride
Patrick Keown, MRCPsych, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Orla McBride, PhD, School of Psychology, University of Ulster, County Londonderry, Ulster; Liz Twigg, PhD, Department of Geography, University of Portsmouth, Portsmouth; David Crepaz-Keay, DProf, Mental Health Foundation, London; Eva Cyhlarova, DPhil, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford; Helen Parsons, PhD, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry; Jan Scott, MD, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Kamaldeep Bhui, MD, Centre for Psychiatry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London; Scott Weich, MD, Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
Liz
L
Twigg
Patrick Keown, MRCPsych, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Orla McBride, PhD, School of Psychology, University of Ulster, County Londonderry, Ulster; Liz Twigg, PhD, Department of Geography, University of Portsmouth, Portsmouth; David Crepaz-Keay, DProf, Mental Health Foundation, London; Eva Cyhlarova, DPhil, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford; Helen Parsons, PhD, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry; Jan Scott, MD, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Kamaldeep Bhui, MD, Centre for Psychiatry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London; Scott Weich, MD, Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
David
D
Crepaz-Keay
Patrick Keown, MRCPsych, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Orla McBride, PhD, School of Psychology, University of Ulster, County Londonderry, Ulster; Liz Twigg, PhD, Department of Geography, University of Portsmouth, Portsmouth; David Crepaz-Keay, DProf, Mental Health Foundation, London; Eva Cyhlarova, DPhil, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford; Helen Parsons, PhD, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry; Jan Scott, MD, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Kamaldeep Bhui, MD, Centre for Psychiatry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London; Scott Weich, MD, Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
Eva
E
Cyhlarova
Patrick Keown, MRCPsych, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Orla McBride, PhD, School of Psychology, University of Ulster, County Londonderry, Ulster; Liz Twigg, PhD, Department of Geography, University of Portsmouth, Portsmouth; David Crepaz-Keay, DProf, Mental Health Foundation, London; Eva Cyhlarova, DPhil, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford; Helen Parsons, PhD, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry; Jan Scott, MD, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Kamaldeep Bhui, MD, Centre for Psychiatry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London; Scott Weich, MD, Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
Helen
H
Parsons
Patrick Keown, MRCPsych, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Orla McBride, PhD, School of Psychology, University of Ulster, County Londonderry, Ulster; Liz Twigg, PhD, Department of Geography, University of Portsmouth, Portsmouth; David Crepaz-Keay, DProf, Mental Health Foundation, London; Eva Cyhlarova, DPhil, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford; Helen Parsons, PhD, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry; Jan Scott, MD, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Kamaldeep Bhui, MD, Centre for Psychiatry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London; Scott Weich, MD, Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
Jan
J
Scott
Patrick Keown, MRCPsych, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Orla McBride, PhD, School of Psychology, University of Ulster, County Londonderry, Ulster; Liz Twigg, PhD, Department of Geography, University of Portsmouth, Portsmouth; David Crepaz-Keay, DProf, Mental Health Foundation, London; Eva Cyhlarova, DPhil, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford; Helen Parsons, PhD, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry; Jan Scott, MD, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Kamaldeep Bhui, MD, Centre for Psychiatry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London; Scott Weich, MD, Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
Kamaldeep
K
Bhui
Patrick Keown, MRCPsych, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Orla McBride, PhD, School of Psychology, University of Ulster, County Londonderry, Ulster; Liz Twigg, PhD, Department of Geography, University of Portsmouth, Portsmouth; David Crepaz-Keay, DProf, Mental Health Foundation, London; Eva Cyhlarova, DPhil, Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford; Helen Parsons, PhD, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry; Jan Scott, MD, Academic Psychiatry, Campus for Ageing & Vitality, Newcastle University, Newcastle upon Tyne; Kamaldeep Bhui, MD, Centre for Psychiatry, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London; Scott Weich, MD, Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.
Scott
S
Weich
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data*; D008131:London / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult