Hostname: page-component-5cf477f64f-n7lw4 Total loading time: 0 Render date: 2025-04-04T08:45:11.075Z Has data issue: false hasContentIssue false
  • English
  • Français

The Nottingham Acute Bed Study: Alternatives to acute psychiatric care

Published online by Cambridge University Press:  03 January 2018

A. Beck ,
T. J. Croudace ,
S. Singh  and
G. Harrison
A. Beck*
Affiliation:
Academic Department of Psychiatry, University of Nottingham, Nottingham
T. J. Croudace
Affiliation:
Academic Department of Psychiatry, University of Nottingham, Nottingham
S. Singh
Affiliation:
Academic Department of Psychiatry, University of Nottingham, Nottingham
G. Harrison
Affiliation:
Academic Department of Psychiatry, University of Nottingham, Nottingham
*
Dr T. Croudace, Academic Department of Psychiatry, University of Nottingham, Professorial Unit, Duncan Macmillan House, Porchester Road, Nottingham NG3 6AA
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Although modern psychiatric services seek alternatives to hospitalisation wherever appropriate, the national trend toward higher bed occupancies on acute psychiatric wards has refocused attention on community-based alternatives and methods of assessing reed for acute care.

Method

We surveyed key decision makers in a community-oriented district service with a low acute psychiatric bed to population ratio, in order to examine alternatives to hospitalisation in a cohort of consecutive admissions over a six-month period.

Results

Alternatives to acute ward hospitalisation were identified for 29% of admissions, and for 42% of those with an admission duration of more than 60 days. Residential options were chosen more often than intensive community support. Simulated bed day savings were considerable.

Conclusions

In a community-oriented service, key decision-makers could identify further alternatives to acute ward hospitalisation, although relatively few non-residential, community support options were chosen. Although this methodology has limitations, data based upon keyworker judgements probably have greater local ‘ownership’, and the option appraisal process itself may challenge stereotyped patterns of resource use.

Type
Papers
Information
The British Journal of Psychiatry , Volume 170 , Issue 3 , March 1997 , pp. 247 - 252
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Audit Comimission (1994) Finding a Place: A Review of Mental Health Services. London: Her Majesty's Stationery Office.Google Scholar
Burns, T. & Kant, A. (1994) Failure in community care. Inpatient care is part of the integrated approach. British Medical Journal. 308, 1235–1236.Google Scholar
Creed, F., Black, D., Anthony, P., et al (1991) Randomised controlled trial of day and in-patient treatment. 2: Comparison of two hospitals. British Journal of Psychiatry 158, 183–189.Google Scholar
Davies, S., Payne, S. & Jenldna, J. (1994) Impact of new long-stay patients (letter). British Journal of Psychiatry. 145, 840–841.CrossRefGoogle Scholar
Flanigan, C. B., Glover, G. R., Feenay, S. T., et al (1994a) Inner London collaborative audit of admissions in two Health Districts. I: Introduction, method and preliminary findings. British Journal of Psychiatry. 145, 734–742.Google Scholar
Flanigan, C. B., Glover, G. R., Feenay, S. T., Wing, J. K., et al (1994b) Inner London collaborative audit of admissions in two Health Districts, III: Reasons for acute admissions to acute psychiatric wards. British Journal of Psychiatry, 145, 750–759.Google Scholar
Fulop, N. J., Koffman, J., Carson, S., et al (1994) Use of psychiatric beds: a point prevalance survey in North and South Thames regions, Journal of Public Health Medicine, 18, 207–216.Google Scholar
Glover, G. R. (1994) Using the Mental Illness Needs Index Programme. London: Department of PutMic Health and Primary Care. Charing Cross and Westminster Medical School.Google Scholar
Hirsch, S. R. (1987) Planning for bed needs and resource requirennents in acute psychiatry. Bulletin of the Royal College of Psychiatrists, II. 398–407.Google Scholar
Hollander, D. & Slatar, M. S. (1994) Sorry no beds': a problem for acute psychiatric admissions. Psychiatric Bulletin, 18, 532–534.Google Scholar
Klulter, H., Gial, R., Nlanhuls, F. J., et al (1992) Predicting feasibility of day treatment for unselected patients referred for inpatient psychiatric treatnrient: results of a randomised trial. American Journal of Psychiatry, 149, 1100–1205.Google Scholar
MILMIS Project Group (1995) Monitoring inner London mental illness services. Psychiatric Bulletin. 19, 276–280.CrossRefGoogle Scholar
Muijan, M. & Hadlay, T. (1995) Community care: parts and systems. In Schizophrenia (eds Hirsch, S. & Weinberger, D. R.), pp. 649–663. Oxford: Blackwell Science.Google Scholar
Rugari, M. & Tansalla, M. (1995) Evaluating outcome in mental health care. Current Opinion in Psychiatry 8, 116–121.Google Scholar
Tyrer, P., Morgan, J., van Horn, E., et al (1995) A randomised study of close monitoring of vulnerabte psychotic patients. Lancet. 345, 756–759.CrossRefGoogle Scholar
World Health Organization (1992) The ICD-10 Classification of Mental and Behavioural Disorders. Geneva: WHO.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.