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Reducing the revolving door phenomenon.

Antoinette Daly1, Donna Tedstone Doherty1, Dermot Walsh1

  • 1Mental Health Research Unit,Health Research Board,Knockmaun House,42-47 Lower Mount Street,Dublin 2,Ireland.

Irish Journal of Psychological Medicine
|October 5, 2018
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This summary is machine-generated.

Despite reduced inpatient admissions, over 70% of mental health admissions in Ireland are readmissions. Enhancing community-based services and outreach programs is crucial to reduce the "revolving door" phenomenon and improve patient care.

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Area of Science:

  • Mental Health Services Research
  • Health Policy Analysis
  • Community Psychiatry

Background:

  • De-institutionalisation and community service expansion in Ireland reduced inpatient admissions by 31% (1986-2006).
  • Readmissions constitute over 70% of all mental health admissions, indicating persistent challenges in care continuity.
  • The policy document 'A Vision for Change' highlighted shortcomings and recommended enhanced community-based services, including outreach.

Purpose of the Study:

  • To review the recommendations of 'A Vision for Change' concerning community-based mental health services.
  • To analyze the potential impact of these recommendations on reducing mental health readmissions in Ireland.
  • To examine the relationship between community service provision and inpatient admission rates.

Main Methods:

  • Discussion of three key intervention programs recommended by 'A Vision for Change'.
  • Pearson correlation analysis between Irish inpatient admissions and community service utilization.
  • Review of international literature on the effectiveness of community interventions in reducing readmissions.

Main Results:

  • While 'A Vision for Change' advocates for a person-centred model, high readmission rates persist, signaling service gaps.
  • Specialized community-based care programs are scarce and unevenly distributed across Ireland.
  • Quantitative and qualitative improvements in community services are needed to address the revolving door phenomenon.

Conclusions:

  • Significant improvements in the provision and distribution of specialized community mental health services are necessary.
  • Reconfiguring existing catchment populations is essential for the successful implementation and expansion of these services.
  • Addressing service shortcomings is critical to reduce high readmission rates and the 'revolving door' phenomenon in Irish mental health care.