The impact of severe mental illness, co-morbid personality disorders and demographic factors on psychiatric bed use

Background The use of inpatient psychiatric services has been correlated with certain demographic and clinical variables. However, there is limited information about the impact of personality disorder. Aims To describe the impact of severe mental illness, personality disorders and demographic variables on psychiatric bed use amongst people in contact with a Community Mental Health Team (CMHT).Method Twoyear retrospective and 2-year prospective bed use by the caseload of one Community Mental Health Team. Results Psychotic disorders (odds ratio 2.7), personality disorders (OR 2.2), marital status (OR 2.1) and unemployment (OR 1.9) were significantly related to psychiatric admissions from community care. Gender, accommodation, drug and alcohol problems, and ethnicity were not. Conclusions Psychosis, personality disorder and unemployment appear to have independent effects on psychiatric bed use. Patients with a combination of psychotic disorders and diffuse personality disorders were very high users of inpatient services. This suggests that this group have particular needs that community mental health teams find difficult to manage.