Inpatient days
The total number of inpatient days spent by psychiatric patients in Ireland in 2019 was 1,074,232.
The 16,710 admissions were categorised as follows:
- Organic mental disorders – 383,
- alcoholic disorders – 1,090,
- other drug disorders – 1,090,
- schizophrenia and delusional disorders – 3,540,
- depressive disorders – 4,088,
- mania – 1,689,
- neuroses – 1,686,
- eating disorders – 138,
- personality and behavioural disorders – 1,406,
- intellectual disability – 78,
- development disorders – 44,
- child behavioural and emotional disorders – 23,
- other and unspecified – 1,455.
Split
Admissions were almost equally split between the sexes, with 8,509 male inpatient stays and 8,201 females admitted.
County Carlow had the highest number of psychiatric admissions, for all diagnoses, at 454.9 per 100,000 total population, followed by Leitrim at 443.1.
Dublin stood at 379.5, with Cork at 376.2. The lowest admission rates were in Monaghan, at 175.9 per 100,000 of population.
And 297 homeless people were admitted to psychiatric units in 2019.
One third of these were aged between 35 and 44, with just over one quarter aged between 25 and 34.
One homeless adolescent male was admitted to a psychiatric unit, but eight young men aged between 18-19 were admitted.
Homeless
Of the homeless people admitted, 28.28% were suffering from schizophrenia. Just 7.74% had an alcoholic disorder while 16.84% had another drug disorder.
Over three-quarters of homeless people admitted were single, with just under 5% married.
85.93% of admissions to psychiatric units were voluntary with 14.07% involuntary.
Just under 30% of admissions were for less than a week, with 27.69% of cases admitted for between one and three months.
A further 17.44% stayed for between one and two weeks, while 19.61% had stays of between two and four weeks. Just under 5% stayed in psychiatric units for three months to a year.
Adult settings
An increased number of children and adolescents were admitted to dedicated child and adolescent psychiatric units, with fewer in adult settings.
Of the 497 children admitted to psychiatric units and hospitals in 2019, 54 were admitted to adult psychiatric units and hospitals, a decrease from 84 in 2018.
The number of admissions does not necessarily equate to the actual number of children admitted, as an individual child may be admitted on more than one occasion in any given year.
However, there are increasing numbers of under-18s admitted to psychiatric facilities, up from 408 admissions in 2018 to 497 in 2019.
The HRB says this could reflect an increase in the number of places, a real increase in admissions, or a combination of both.
Admissions among young girls remain consistently high in relation to their male counterparts, with 65% of admissions being female.
While depression remained the most common diagnosis among children, admissions for an eating disorder increased from 33 in 2018 to 54 in 2019.
This increase is particularly notable in females – girls and young women accounted for 96% of admissions with an eating disorder.
This is an increase from 80% in 2018.
Grave concern
Minister of State with responsibility for Mental Health and Older People Mary Butler said this is an area of grave concern which will need to be prioritised.
"The consistently disproportionate numbers of girls and young women being admitted to psychiatric units and hospitals is a worrying trend that will need to be focused on and addressed,” she said,
The Child and Adolescent Mental Health Service (CAMHS) has seen a 25% increase in referrals between 2012 and 2019 while waiting list numbers increased from around 2,400 to 2,500 in that time.
Case complexity
Case complexity has also increased over recent years. In 2008, there were 16 CAMHS acute inpatient beds. By year-end 2019 this figure had increased to 74.
In 2008 there were 49 CAMHS teams, up to 71 in 2019.
A new 10-bed forensic CAMHS unit will open in 2021 at the National Forensic Mental Health Service (NFMHS) at Portrane, in Dublin north county, following opening of the main hospital in late 2020.
A further 20 CAMHS beds are planned for the National Children’s Hospital (including eight beds for eating disorders). This will increase overall national bed provision from 74 to 104.