In-patient service use before and after a mental health in-patient rehabilitation admission

In-patient mental health rehabilitation services provide specialist treatment to people with complex psychosis. On average, rehabilitation admissions last around a year and usually follow several years of recurrent and often lengthy psychiatric hospital admissions.

To compare in-patient service use before and after an in-patient rehabilitation admission, using electronic patient healthcare records in one National Health Service Trust in London.

We carried out a retrospective cohort study comprised of individuals with an in-patient rehabilitation admission lasting ≥84 days between 1 January 2010 and 30 April 2019, with at least ≥365 days of records available before and after their rehabilitation admission. We used negative binomial regression models to compare the number of in-patient days before and after the rehabilitation admission.

A total of 172 individuals met our eligibility criteria. The median percentage of days spent as an in-patient before the rehabilitation admission was 29% (interquartile range 18-52%), and 8% (interquartile range 0-31%) after the admission. The regression model adjusted for potential confounder variables produced an incidence rate ratio of 0.520 (95% CI 0.367-0.737).

The rate of in-patient service use was halved in the period after an in-patient rehabilitation admission compared with the period before. This suggests that in-patient rehabilitation is a clinical and cost-effective intervention in the treatment and support of people with complex psychosis.