Psychiatric In-patients and Out-patients in a London Borough

Abstract

In a London borough all admissions to a psychiatric bed and all new psychiatric out-patient referrals were studied during a twelve-month period. The female admission rate increased steadily with age. The admission rate for the over 653 of both sexes was 4.90 per 1,000. In contrast, increasing age was associated with a gradual fall of out-patient referral rate to 1.60 per 1,000 for the over 653. Other categories under-represented among out-patients were the single and the `previously married', and social classes IV and V. The diagnostic distribution of in-patients differed from that observed in out-patients, but affective disorders were the largest group in both. Two-thirds of out-patients but only one-third of in-patients were directly referred by their general practitioners. Nineteen per cent of out-patients were admitted to psychiatric beds, with one in four female but only one in ten male out-patients becoming in-patients. Among out-patients admitted, the largest diagnostic group was that of affective disorders, and one-third of the patients came from social classes IV and V. The relationship of in-patient and out-patient services—in particular the extent they substitute for, and complement, each other—is discussed.