ACUTE PSYCHIATRIC BEDS - DISTRIBUTION AND STAFFING IN NSW AND ACT

This study examined the availability and staffing of acute psychiatry beds in NSW and ACT. ''Gazetted'' acute psychiatry hospitals (which ta ke compulsory admissions under mental health law) were polled directly for bed numbers, occupancy and staffing for the year 1990-1991. The N SW Department of Health provided beds numbers for non-gazetted and pri vate hospitals. Four analyses sequentially reallocated beds according to the origin of patients to estimate acute bed availability and use b y regional populations. Socio-demographic determinants of acute admiss ion rates were measured. Acute ''gazetted'' beds averaged 13.2 per 100 ,000 population but ranged from 6.9 to 49.1 per 100,000 when cross-reg ional flows were considered. ''Non-gazetted'' beds raised the provisio n to 15.5 per 100,000 and private beds raised provision further to 24. 5 per 100,000. Inner metropolitan provision was higher than rural or p rovincial provision. The only determinant of the admission rate to gaz etted beds was the number of available beds. Bed availability did not affect either bed occupancy or referral of patients to remote hospital s. Nursing staffing of gazetted units was reasonably uniform, although smaller units had significantly more nurses per bed. Medical staffing was highly variable and appears determined by staff availability. The average provision of acute psychiatric beds approximates lowest level s seen in international models for psych iatric services. Average occu pancy rates suggest that there is not an overall shortfall of acute ps ychiatric beds, but uneven bed distribution creates barriers to access . Referral of patients to remote hospitals is not related to actual be d provision in the regions, but appears to reflect attitudes to ensuri ng local care. Recommendations about current de facto standards are ma de. Current average nursing and medical staffing standards are reporte d.