Mentally ill patients released early to free up hospital beds: study
Pauline Tam , Canwest News Service
Canadians hospitalized for mental illness are being discharged earlier than they used to be, suggesting they may be squeezed out because of a shortage of beds, experts say.
Results of a study released Tuesday by the Canadian Institute for Health Information suggest the average length of stay for mentally ill patients admitted to general hospitals dropped by more than half in the five years ending in 2006, to 16 days from 36 days.
Experts attribute the shorter stays in general hospitals to pressure to free up hospital beds, which often results in mentally ill patients being discharged before they are ready
"There's a huge pressure on beds, there are huge demands on the system," said Dr. Patrick White, president of the Canadian Psychiatric Association. "What we're seeing is that patients are sicker, they're more acute, they're more medically unstable. But there's continuous pressure to get patients admitted, treated and out."
White, who's also head of the mental-health program for Edmonton's health authority, said the country's largest hospitals struggle to find beds for patients in crisis because those with chronic mental illness, who could be better treated in the community, are instead hospitalized.
"If we had more supportive housing for people with long-term mental illness, it would free up a significant number of the beds that we would say are blocked," said White.
In other communities, however, a proliferation of new medications and outpatient services has reduced the need for long hospital stays, said Ian Joiner, the health statistics agency's manager of rehabilitation and mental health.
"It indicates to me that there's a changing way that hospitalization or stays in a hospital are being used for people with a mental illness," he said.
General hospitals handle more than 85 per cent of mental-health cases, according to the institute. Stays in dedicated psychiatric hospitals also were shorter, but still averaged more than 100 days.
Among the provinces, patients in New Brunswick and Manitoba reported the longest average general-hospital stays (24 days), while Nunavut had the shortest (three days). Patients in Ontario spent an average of 12 days in hospital.
Overall, mental illness in Canada accounted for nearly 171,000 admissions to general hospitals and 2.8 million days stayed in 2005-06, according to the report.
The bulk of Canadians admitted were men between the ages of 25 to 44, with more than half suffering more than one psychiatric condition.
Mood disorders such as depression and bipolar disorder were the most common type of mental illnesses leading to hospital treatment, followed by schizophrenia, substance abuse, dementia, anxiety and personality disorders.
The exceptions were in the Northwest Territories and the Yukon, where substance abuse was the most common reason for hospitalization.
Average length of hospital stay (in days) by patients with mental illness by province:
New Brunswick - 23.9
Manitoba - 23.5
Quebec - 21.1
Nova Scotia - 19.3
Newfoundland and Labrador - 18.4
Alberta - 16.5
B.C. - 15.0
Saskatchewan - 12.7
Ontario - 12.3
Prince Edward Island - 10.8
Yukon - 6.7
Northwest Territories - 5.9
Nunavut - 3.2
Canada - 16.4
SOURCE: Canadian Institute for Health Information
Pauline Tam , Canwest News Service
Canadians hospitalized for mental illness are being discharged earlier than they used to be, suggesting they may be squeezed out because of a shortage of beds, experts say.
Results of a study released Tuesday by the Canadian Institute for Health Information suggest the average length of stay for mentally ill patients admitted to general hospitals dropped by more than half in the five years ending in 2006, to 16 days from 36 days.
Experts attribute the shorter stays in general hospitals to pressure to free up hospital beds, which often results in mentally ill patients being discharged before they are ready
"There's a huge pressure on beds, there are huge demands on the system," said Dr. Patrick White, president of the Canadian Psychiatric Association. "What we're seeing is that patients are sicker, they're more acute, they're more medically unstable. But there's continuous pressure to get patients admitted, treated and out."
White, who's also head of the mental-health program for Edmonton's health authority, said the country's largest hospitals struggle to find beds for patients in crisis because those with chronic mental illness, who could be better treated in the community, are instead hospitalized.
"If we had more supportive housing for people with long-term mental illness, it would free up a significant number of the beds that we would say are blocked," said White.
In other communities, however, a proliferation of new medications and outpatient services has reduced the need for long hospital stays, said Ian Joiner, the health statistics agency's manager of rehabilitation and mental health.
"It indicates to me that there's a changing way that hospitalization or stays in a hospital are being used for people with a mental illness," he said.
General hospitals handle more than 85 per cent of mental-health cases, according to the institute. Stays in dedicated psychiatric hospitals also were shorter, but still averaged more than 100 days.
Among the provinces, patients in New Brunswick and Manitoba reported the longest average general-hospital stays (24 days), while Nunavut had the shortest (three days). Patients in Ontario spent an average of 12 days in hospital.
Overall, mental illness in Canada accounted for nearly 171,000 admissions to general hospitals and 2.8 million days stayed in 2005-06, according to the report.
The bulk of Canadians admitted were men between the ages of 25 to 44, with more than half suffering more than one psychiatric condition.
Mood disorders such as depression and bipolar disorder were the most common type of mental illnesses leading to hospital treatment, followed by schizophrenia, substance abuse, dementia, anxiety and personality disorders.
The exceptions were in the Northwest Territories and the Yukon, where substance abuse was the most common reason for hospitalization.
Average length of hospital stay (in days) by patients with mental illness by province:
New Brunswick - 23.9
Manitoba - 23.5
Quebec - 21.1
Nova Scotia - 19.3
Newfoundland and Labrador - 18.4
Alberta - 16.5
B.C. - 15.0
Saskatchewan - 12.7
Ontario - 12.3
Prince Edward Island - 10.8
Yukon - 6.7
Northwest Territories - 5.9
Nunavut - 3.2
Canada - 16.4
SOURCE: Canadian Institute for Health Information
It's a shame really...
