Mental health service users' pre- and post-therapy hospitalization rates: A data linkage study

To examine the long-term impact of psychological therapy on physical and mental health hospitalizations.

The study design combined case control and data linkage methodologies. Data from 3742 psychological therapies service (PTS) service users and 72,500 matched controls were merged with hospitalizations data in Northern Ireland. Acute hospitalizations were classified and included in the analyses if ICD codes were assigned to the patient's continuous period of stay in a primary or secondary position for: (1) mental health; or (2) physical health conditions linked to mental health (e.g., diabetes, musculoskeletal disorders). The ICD codes were used to indicate if the conditions were present during four periods of interest: 1st and 2nd year pre-referral and 1st and 2nd year post-discharge. The number of days spent in hospital under each code was also computed. Hospitalizations data were sourced from Honest Broker Service.

Compared with matched controls, PTS service users were more likely to have been hospitalized for all mental and physical health conditions examined in the 1st and 2nd years' pre-referral for therapy. PTS clients also had significantly longer durations of stay for overall hospitalizations prior to referral for therapy. However, by 2nd year post-therapy, PTS service users were no more likely to be hospitalized for mental health reasons than matched controls, with no significant differences in duration of stay for overall hospitalizations.

The findings provide new insight into the potential long-term protective role of psychological therapy in preventing acute mental health hospitalizations 2 years post-discharge.