An involuntary admission, sometimes called a collocation, is intended as a protective measure. A patient can be ordered into involuntary admission by a magistrate if he or she is a danger to him or herself or to others. These patients are usually admitted to a PH.
The number of involuntary admissions is clearly increasing, especially in the Flemish Region. This observation reinforces our belief that crisis psychiatry, both in outpatient and residential settings, is essential.
Evolution of the number of involuntary admissions
in psychiatric services for adults per region in PH and PDGH
| PH | PDGH |
On the one hand, we observe a reduction in the duration of stay, but on the other hand, we see that, after discharge, patients are readmitted the same year, to the same hospital.
This is usually limited to a single readmission in the same year, but more frequent readmissions are becoming more common.[1]
Number of repeat admissions to psychiatric services for adults in PH and PDGH (2018)
[1] It should be borne in mind that there is no unique patient identification number within Minimum Psychiatric Data. As a result, a patient can only be monitored within the same hospital, and readmissions in other hospitals cannot be accounted for. This may result in an underestimation of the number of readmissions.
Three quarters of stays in psychiatric services for adults in PH last less than 3 months. Around 14.4% of the stays in the PH last less than one week. In the psychiatric services for adults in PDGH, almost 80% of stays last less than one month. One third of the stays even last less than one week. We can also observe that in PH, few stays end on the same day, while this happens more regularly in the PDGH.
Duration of stay in psychiatric services for adults in PH and PDGH
The average number of occupant days per year[1] in a PDGH is significantly lower than in a PH. This is due to the acute treatment of patients that takes priority in a PDGH. In addition, the average number of occupant days per year remains about the same over the years, while in the PH it is shortened by an average of 20 days (26%) compared to 2005.
Evolution of the number of hospital stays
in psychiatric services for adults in PH and PDGH by age
[1] The average number of occupant days was calculated as the total number of occupant days in relation to the number of hospitalisations in a given year. As a result, this does not relate to the average duration of stay as the number of occupant days in a previous year was not taken into account. For this calculation, both partial and residential stays were taken into account.
In 2018, a total of 122,403 stays (residential and partial) were registered in psychiatric services for adults in PH and PDGH. Of these, 66,142 were stays in PH and 56,261 in PDGH[1],[2]. This means that, in comparison with 2005, the number of stays increased by 13.3% in PH and by 16.3% in PDGH. In addition, we can observe that the evolution of the number of stays in PDGH is almost parallel to that in PH.
Evolution of the number of hospital stays
in psychiatric services for adults in PH and PDGH
We observe that the total number of stays is the same for men and women. We do however observe a clear difference in the type of facility where a man or a woman is treated for his/her problems. Namely, we see men are more likely to be admitted to a PH.
Evolution of the number of hospital stays in psychiatric services for adults
in PH and PDGH by gender[3]
| Men | Women |
The increase in the number of stays in PH and PDGH is situated within the active population (19-64 years old), whereby we observe a strong increase in the group of 19 to 40 year olds between 2013 and 2016[4].
Evolution of the number of hospital stays in psychiatric services for adults
in PH and PDGH by age[5]
[1] Source: Minimum Psychiatric Data (MPD), FPS Health, Food Chain Safety and Environment
[2] This concerns the number of registered residential and partial stays in beds for adults (all code letters except K, k1, k2, Tf) in the year in question regardless of the year of admission and regardless of whether the patient has already been discharged.
[3] Stays for which the sex of the patient is not known, have not been taken into account.
[4] For the sake of completeness, the category of 0-18 year olds is also indicated. In exceptional cases, children and young people may be admitted to a psychiatric service for adults. Furthermore, stays in the 0-18 year-old category may be the result of incorrect registration.
[5] Stays for which the age of the patient is not known, have not been taken into account.