[The aftermath of the reduction in inpatient care and treatment; a retrospective study that considers the extent to which a group of chronic psychiatric patients made use of the Amsterdam mental health services]

Abstract

Background: The move towards less hospital care and more community care for psychiatric patients began in the eighties. Chronic patients possibly have not really benefited from the new procedures.

Aim: To find out whether chronic psychiatric patients in Amsterdam were receiving adequate care and made good use of the available psychiatric services.

Method: We amalgamated the registration details of three mental health care institutions in Amsterdam over the period 1-1-2000 to 1-1-2005.

Results: In 2005 4576 patients met the criteria for chronic mental illness. In five years, the number of patients in mental health care had risen by 50%. Most of these patients had received care via specialised programmes. 38% of chronic patients had no access to specialised programmes, many of which had waiting lists. Only 6.5% of chronic patients received long-term inpatient care. Not many long-term psychiatric patients used the acute psychiatric services. Each year only 10% of long-term psychiatric patients were admitted to a psychiatric hospital. If admitted, they spent a much longer time in hospital. The average number of days spent in hospital rose from 86 in 2000 to 131 in 2004. Crisis contacts increased in line with the increase in the numbers of chronic patients in care, but these crisis contacts were registered mainly with the patient treatment team and not with the municipal acute psychiatric service.

Conclusion: Only a small proportion of long-term psychiatric patients make use of the acute psychiatric services.