Number Of Mental Hospital Beds Research Articles

National levels of human development and number of mental hospital beds.

The number of mental hospital beds per population varies widely across countries, and the reasons for this variation are not fully understood. Given that differences in disease prevalence do not explain variation in inpatient mental health care availability, we examined the relationship between mental hospital beds and national income, education and longevity as measured by the Human Development Index (HDI). We used an international dataset of social, economic and structural measures to conduct a mixed-effects longitudinal regression of predictors of the number of mental hospital beds per 100 000 in the overall population for 86 countries for years 2005-2015. Our initial dataset contained 1881 observations consisting of 11 years of potential measurements across 171 countries. After eliminations based on missing data and subsequent imputation, the dataset for the final regression model included 946 observations over 86 countries. The primary predictors of a country's number of mental hospital beds were year, HDI and GINI coefficient, the latter being a measure of income disparity. Holding all other factors constant, the number of beds decreased 8% per year, reflecting the ongoing international trend of deinstitutionalisation. As hypothesised, higher HDI predicted more mental hospital beds. Every 0.1 increase in HDI (0-1.0) was associated with a 126% increase in the number of hospital beds at the sample's mean GINI index score of 38 (0-100). However, a strong interaction between HDI and the GINI coefficient indicated that a high level of income disparity attenuated the positive association between HDI and mental hospital beds. At a GINI index score of 48, every 0.1 increase in HDI was associated with a 71% increase in the number of hospital beds. As countries reduce the number of hospital beds over time, higher levels of economic disparity are associated with a reduction in the strength of the association between national prosperity and investment in mental hospitals. As power becomes increasingly concentrated, perhaps those with the least are more easily forgotten.

Penrose's Law revisited: The relationship between mental institution beds, prison population and crime rate

In 1939, Lionel Penrose published a cross-sectional study from 18 European countries, including the Nordic, in which he demonstrated an inverse relationship between the number of mental hospital beds and the number of prisoners. He also found strong negative correlations between the number of mental hospital beds and the number of deaths attributed to murder. He argued that by increasing the number of mental institution beds, a society could reduce serious crimes and imprisonment rates. The aim of the study was to test Penrose's theories longitudinally by monitoring the capacity of all psychiatric institutions and prisons in a society over time. From official statistics, we collected and systematized all relevant information regarding the number of mental institution beds and prisoners in Norway during the years 1930–2004, along with major crime statistics for the same period. During the years 1930–59, there was a 2% population-adjusted increase in mental institution beds and a 30% decrease in the prison population. During 1960–2004, there was a 74% population-adjusted decrease in mental institution beds and a 52% increase in the prison population. The same period saw a 500% increase in overall crime and a 900% increase in violent crimes, with a concurrent 94% increase in the size of the country's police force. Penrose's law proved remarkably robust in the longitudinal perspective. As opposed to Penrose, however, we argue that the rise in crime rates only to a very limited extent can be attributed to mental health de-institutionalization.

Care of chronic mental patients in The Netherlands.

While the Dutch Government is actively planning to reduce the number of mental hospital beds, particularly those for long-stay patients, it takes little notice of the reality of mental health care in The Netherlands, cherishing various misconceptions regarding institutionalism and community care. On the basis of a case-register study the population of chronic mental patients is estimated, including their current discharge rate from mental hospital without any aftercare. The burden of the mentally disabled on the community is discussed.

I.Q. CHANGES IN CHRONIC SCHIZOPHRENIA.

The question of the long-stay mental hospital population has recently received a great deal of attention. Proposals, based on the statistics of mental hospital admissions and discharges over the last few years, the increasing development of day hospitals, out-patient clinics, psychiatric units attached to general hospitals, and community services for the mentally ill within the general framework of new and improved methods of treatment, have led to considerable thought as to how best to reintegrate former mental hospital patients into the community. The process of discharging long-stay patients has, of course, been continuous, but the numbers involved have been comparatively small in the past. A policy of reducing considerably the number of mental hospital beds depends partly on aiming at the highest possible maintenance capacity of discharged patients. For long-stay female patients this would involve, among other aims, the re-training in domestic skills to adequate levels, while in male patients the aim would have to be some form of industrial resettlement. The general aim of increasing the activity and skill level of long-stay mental patients has found its expression in the establishment of industrial workshops. From its early beginnings (Baker, 1956) this form of therapy has developed into the establishment of production workshops or factories both inside and outside the walls of mental hospitals. (Wadsworth, Scott and Tonge, 1958; Early, 1960; Cooper and Early, 1961; Wadsworth et al 1961, 1962.)