In-patient service use before and after a mental health in-patient rehabilitation admission

Background In-patient mental health rehabilitation services provide specialist treatment to people with complex psychosis. On average, rehabilitation admissions last around a year and usually follow several years of recurrent and often lengthy psychiatric hospital admissions. Aims To compare in-...

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Main Authors: Christian Dalton-Locke, Louise Marston, Justin Yang, David Osborn, Helen Killaspy
Format: Article
Language:English
Published: Cambridge University Press 2025-05-01
Series:BJPsych Open
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Online Access:https://www.cambridge.org/core/product/identifier/S2056472425000316/type/journal_article
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author Christian Dalton-Locke
Louise Marston
Justin Yang
David Osborn
Helen Killaspy
author_facet Christian Dalton-Locke
Louise Marston
Justin Yang
David Osborn
Helen Killaspy
author_sort Christian Dalton-Locke
collection DOAJ
description Background In-patient mental health rehabilitation services provide specialist treatment to people with complex psychosis. On average, rehabilitation admissions last around a year and usually follow several years of recurrent and often lengthy psychiatric hospital admissions. Aims To compare in-patient service use before and after an in-patient rehabilitation admission, using electronic patient healthcare records in one National Health Service Trust in London. Method We carried out a retrospective cohort study comprised of individuals with an in-patient rehabilitation admission lasting ≥84 days between 1 January 2010 and 30 April 2019, with at least ≥365 days of records available before and after their rehabilitation admission. We used negative binomial regression models to compare the number of in-patient days before and after the rehabilitation admission. Results A total of 172 individuals met our eligibility criteria. The median percentage of days spent as an in-patient before the rehabilitation admission was 29% (interquartile range 18–52%), and 8% (interquartile range 0–31%) after the admission. The regression model adjusted for potential confounder variables produced an incidence rate ratio of 0.520 (95% CI 0.367–0.737). Conclusions The rate of in-patient service use was halved in the period after an in-patient rehabilitation admission compared with the period before. This suggests that in-patient rehabilitation is a clinical and cost-effective intervention in the treatment and support of people with complex psychosis.
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spelling doaj-art-ddb642c8e3de4641881c49d37b4b00192025-08-20T01:50:30ZengCambridge University PressBJPsych Open2056-47242025-05-011110.1192/bjo.2025.31In-patient service use before and after a mental health in-patient rehabilitation admissionChristian Dalton-Locke0https://orcid.org/0000-0002-1876-4741Louise Marston1https://orcid.org/0000-0002-9973-1131Justin Yang2https://orcid.org/0000-0003-2881-4906David Osborn3https://orcid.org/0000-0003-2519-1539Helen Killaspy4https://orcid.org/0000-0003-2481-4802Division of Psychiatry, University College London, London, UKResearch Department of Primary Care and Population Health, University College London, UCL Medical School, London, UKCamden and Islington NHS Foundation Trust, St Pancras Hospital, London, UKDivision of Psychiatry, University College London, London, UK Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, UKDivision of Psychiatry, University College London, London, UK Camden and Islington NHS Foundation Trust, St Pancras Hospital, London, UK Background In-patient mental health rehabilitation services provide specialist treatment to people with complex psychosis. On average, rehabilitation admissions last around a year and usually follow several years of recurrent and often lengthy psychiatric hospital admissions. Aims To compare in-patient service use before and after an in-patient rehabilitation admission, using electronic patient healthcare records in one National Health Service Trust in London. Method We carried out a retrospective cohort study comprised of individuals with an in-patient rehabilitation admission lasting ≥84 days between 1 January 2010 and 30 April 2019, with at least ≥365 days of records available before and after their rehabilitation admission. We used negative binomial regression models to compare the number of in-patient days before and after the rehabilitation admission. Results A total of 172 individuals met our eligibility criteria. The median percentage of days spent as an in-patient before the rehabilitation admission was 29% (interquartile range 18–52%), and 8% (interquartile range 0–31%) after the admission. The regression model adjusted for potential confounder variables produced an incidence rate ratio of 0.520 (95% CI 0.367–0.737). Conclusions The rate of in-patient service use was halved in the period after an in-patient rehabilitation admission compared with the period before. This suggests that in-patient rehabilitation is a clinical and cost-effective intervention in the treatment and support of people with complex psychosis. https://www.cambridge.org/core/product/identifier/S2056472425000316/type/journal_articleMental health servicesrehabilitationin-patient treatmentelectronic healthcare recordspsychotic disorders/schizophrenia
spellingShingle Christian Dalton-Locke
Louise Marston
Justin Yang
David Osborn
Helen Killaspy
In-patient service use before and after a mental health in-patient rehabilitation admission
BJPsych Open
Mental health services
rehabilitation
in-patient treatment
electronic healthcare records
psychotic disorders/schizophrenia
title In-patient service use before and after a mental health in-patient rehabilitation admission
title_full In-patient service use before and after a mental health in-patient rehabilitation admission
title_fullStr In-patient service use before and after a mental health in-patient rehabilitation admission
title_full_unstemmed In-patient service use before and after a mental health in-patient rehabilitation admission
title_short In-patient service use before and after a mental health in-patient rehabilitation admission
title_sort in patient service use before and after a mental health in patient rehabilitation admission
topic Mental health services
rehabilitation
in-patient treatment
electronic healthcare records
psychotic disorders/schizophrenia
url https://www.cambridge.org/core/product/identifier/S2056472425000316/type/journal_article
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