Admission and prevalence rates for psychiatric facilites in four register areas.

Abstract

Data from psychiatric case registers are analyzed in this comparative study of the utilization of psychiatric services in 4 geographic areas: Hawaii, Maryland, the communities of Monroe County, New York, and Durham, Orange, and Wake Counties in North Carolina. The data show similar patterns despite the different communities and resources. In 1 year 1 to 1.5% received psychiatric services in a public or private inpatient or outpatient facility; 0.6 to 0.85% were under care on a specified day; and 0.4 to 0.8% were admitted to care annually. There is consistent variation in these parameters by age, sex, race, and central city versus other residence. In Monroe County (the only register collecting data from private psychiatrists) an additional 0.4% were seen only by a private psychiatrist in a year. Excluding Hawaii, for which comparable data are not available, hospitalization as an index of serious psychiatric disability Is significantly higher for non-whites, particularly nonwhite males. While other studies showed higher Negro admission rates in state hospitals, this study covers only private, Veterans Administration, and general hospitals. By use of the psychiatric case register, unduplicated admission rates to all inpatient facilities were obtained. The over-all nonwhite rate continued at a high level. A high ratio of nonwhite to white rate exists for every major category of mental disorder except depressive reactions. High total nonwhite rates is shown to be a phenomenon of the central city.