Effects of social and behavioural factors in acute psychiatric admissions, a comparison between inner and outer London

Abstract

In order to compare the influence of social and behavioural problems on admission to acute psychiatric units in inner and outer London we studied 491 consecutive admission notes over a six-month period to units in Hackney and Sutton for information on social, behavioural and mental state factors. 377 subjects came from Hackney and 114 from Sutton. The Hackney notes were significantly more likely to cite all three types of factor but the disparity was stronger for social problems. Aggression (OR 2.45, 95% CI 1.5-4.02), self neglect (OR 1.90, 95% CI 1.10-3.29) and accommodation problems (OR 2.98 95% CI 1.4-6.3) were the strongest individual factors to be found more often in the inner city sample. Factors associated with admission to the inner city site were further analysed by logistic regression. The conclusions are discussed in terms of the extra burden on staff in the inner city unit.