The relationship between social factors and frequent use of psychiatric services

The purpose of the study was to develop a comprehensive demographic, diagnostic and social profile of patients who are heavy service users of hospital and community based services within the South Australian Mental Health Services (SAMHS). This paper concentrates on the relationship of social issues to heavy service use. The 50 heaviest users of public adult acute psychiatric services in a defined catchment area of Adelaide were identified. Data were obtained retrospectively from the case notes over a 3 year study period. All patients' primary therapists were interviewed, as were 35 of the patients. These structured interviews included a variety of psychosocial rating scales investigating disability and social networks. The 50 patients studied were found to be seriously disabled by chronic psychiatric illness, with substance abuse often complicating their management and their ability to live successfully in the community. The study confirms the emergence in the literature of a valid global profile of the heavy service user patient, and indicates that social factors are strongly related to heavy service use.