Research Article

Integrated hospital and community psychiatric services and use of inpatient beds.

BMJ 1989; 299 doi: (Published 29 July 1989) Cite this as: BMJ 1989;299:298
  1. P. Tyrer,
  2. R. Turner,
  3. A. L. Johnson
  1. St Charles's Hospital, London.


    The impact of introducing a divisional psychiatric service based in the community in Nottingham in 1981 on adult psychiatric admissions (patients aged 15-65) was examined with data from the Nottingham case register. During 1980-5 the number of psychiatric admissions fell significantly (4.5% a year) compared with the national figures (0.46% a year). Admissions were reduced most for the diagnoses of affective psychosis and neurotic and personality disorders. The average duration of admission fell by 3.6% a year, and use of inpatient beds fell by 37.5%. Integrating hospital and community psychiatric services by creating sectors is a viable and economically feasible way of improving psychiatric services.