Time trends in mental health care utilization in a Dutch area, 1976-1990

This paper concerns time trends in mental health care utilization in a Dutch area from 1976 to 1990. In general, there was an increase in the use of psychiatric services during the study period, both in terms of the number of new patients (per 1000 population) and in terms of the amount of care utilized per patient. When only intramural services were taken into account the number of new psychiatric patients remained approximately constant, but the number of patients in care at a certain point in time (point prevalence) showed a rising trend. For most part, the increase in inpatient point prevalence rates could be ascribed to the increase in the elderly population (75 years or more). In addition to the proportional increase of the ageing population, a growing amount of psychosocial problems and broadening of the concept of illness were tentatively assumed to be related to the increase in mental health care utilization. Unlike some other countries, deinstitutionalization hardly occurred in the Netherlands.