Psychiatric bed utilization: 1896 and 1996 compared

Background. The 1896 and 1996 populations of North West Wales are similar i n number. ethnic and social mix and rurality, enabling a study of the compa rative incidence and prevalence of service utilization over the course of a century. Methods. We collected records on all psychiatric admissions from North-West Wales in 1894-1896 and 1996. These were assessed and diagnosed by the resp onsible sector area consultant. Results. The data reveal substantially more patients admitted for all diagn oses in 1996, even when comparisons are restricted to detained patients. Th e incidence of hospitalization by detention for schizophrenia is slightly l ower 1996 than in 1896 but the incidence of hospitalization is higher now t han in 1996. The incidence of hospitalization by detention for non-affectiv e disorder psychoses is the same in both 1896 and 1996 but there is a doubl ing of incidence of hospitalization. The incidence of hospitalization for b ipolar disorders is similar in the two periods. Modern mental health servic es admit large numbers of personality disordered patients, where none were admitted 100 years ago. Conclusions, Factors general to changing health care and expectations and o thers specific to mental health would appear to have led to the increase in rates of admissions observed in the modern period.