Article2008

Patterns of admission to acute psychiatric in-patient facilities: a national survey in Italy

Antonio Preti · Paola Rucci · Giovanni Santone · Angelo Picardi · Rossella Miglio · Renata Bracco +2 more

66 citations0/0 files storedPsychological Medicine

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Psychiatric care and mental health services Mental Health Treatment and Access Healthcare Decision-Making and Restraints

Abstract

BACKGROUND: A proper understanding of patterns of care represents a crucial step in improving clinical decision making and enhancing service provision. Only a few studies, however, have explored global patterns of psychiatric admissions nationwide, and none have been undertaken in Italy. METHOD: Sociodemographic, clinical and treatment-related information was collected for 1577 patients admitted to 130 public and 36 private in-patient facilities in Italy during an index period in the year 2004. All patients were also rated using the 24-item Brief Psychiatric Rating Scale (BPRS) and the Personal and Social Performance (PSP) rating scales. RESULTS: Non-affective psychoses (36%) were the most common diagnoses and accounted to a large extent for compulsory admissions. Private facilities were more likely to admit patients with organic mental disorders and substance abuse/dependence and less likely to admit patients with non-affective psychoses. Overall, 77.8% of patients had been receiving treatment by a mental health professional in the month prior to admission. In 54% of cases, the admission was solicited by patients' family members. The main factors preceding admission were impairment in work or social functioning, social withdrawal, and conflict with family members. Agitation, delusions and/or hallucinations, and the presence of multiple problems were associated with compulsory admissions, whereas depressive and anxiety symptoms were associated with voluntary admissions. CONCLUSIONS: In a mixed, public-private psychiatric care system, like the Italian one, public and private facilities admit patients with widely different clinical characteristics and needs. Family support represents an important resource for most patients, and interventions specifically addressed to relieving family burden are warranted.

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2004Beliefs about Schizophrenia in Italy: A Comparative Nationwide Survey of the General Public, Mental Health Professionals, and Patients' Relatives 2002The impact of professional and social network support on the burden of families of patients with schizophrenia in Italy 2004Patterns of hospital admission for adult psychiatric illness in England: analysis of Hospital Episode Statistics data 2002The impact of professional and social network support on the burden of families of patients with schizophrenia in Italy.2006Pathways to the First Contact with Specialist Mental Health Care 2001Accessibility and pathways to psychiatric care in a community-based mental health system 2007Characteristics and activities of acute psychiatric in-patient facilities: national survey in Italy 2002Poverty, poor services, and compulsory psychiatric admission in England

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