ArticleBMJ open2016
How has the extent of institutional mental healthcare changed in Western Europe? Analysis of data since 1990.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Transition of Mental Health Services from Institutional to Community-Based Care Abroad and Its Context for Slovenia-Advantages and Risks.International journal of environmental research and public health · 2025Pooled it
- Delivery and delay of guideline pharmacological, psychological, and social interventions for adults with complex psychosis in Dutch inpatient rehabilitation units: A retrospective study.The International journal of social psychiatry · 2026Article
- [Forensic-Psychiatric Consultations in General Psychiatry - Supporting Treatment of Patients Prone to Commit Violence].Fortschritte der Neurologie-Psychiatrie · 2025Article
- How many psychiatric beds are needed-and for what?Der Nervenarzt · 2025Review
- Evaluating referrals to three urban specialist mental health services for people experiencing homelessness over a 1-year period.The International journal of social psychiatry · 2025Article
- Behind closed doors: unlocking hospital variations in the use of seclusion and mechanical restraint - a nationwide multilevel analysis in adult mental healthcare in France.BMC psychiatry · 2025Article
- The role, challenges, and impact of occupational therapists in custodial settings: A scoping review.Australian occupational therapy journal · 2025Article
- Analysing length of stay disparities in inpatient forensic psychiatric care: a cross-sectional study in Czechia.International journal of mental health systems · 2025Article
- Pharmacological treatment and psychiatric polypharmacy in forensic psychiatric care in Sweden.European psychiatry : the journal of the Association of European Psychiatrists · 2025Article
- Comparative Analysis of Violent Crime Statistics in Korea by Mental Illness Status (2012-2022): Implications of Deinstitutionalization.Psychiatry investigation · 2025Article
- Substance use disorders, severe mental illness and risk of reoffending among women released from prison: a national cohort study.Scientific reports · 2025Article
- Changes in the provision of psychiatric beds and incarceration in the Eastern Mediterranean Region from 1990 to 2022.Frontiers in psychiatry · 2025Article
- A multidisciplinary expert consensus on optimal acute adult psychiatric inpatient care in Hong Kong.Frontiers in public health · 2025Article
- Trends in the Diagnostic Prevalence of Mental Disorders, 2012-2022—Using Nationwide Outpatient Claims Data for Mental Health Surveillance.Deutsches Arzteblatt international · 2024Observational
- Highly varying concepts and capacities of forensic mental health services across the European Union.Frontiers in public health · 2023Article
- Changing Features of Liver Injury in COVID-19 Patients: Impact of Infection with the SARS-CoV-2 Delta (B.1.617.2) Variants.Infection & chemotherapy · 2022Article
- The effects of supported housing for individuals with mental disorders.Health economics · 2022Article
- Changes in rates of psychiatric beds and prison populations in sub-Saharan Africa from 1990 to 2020.Journal of global health · 2022Article
- Why did China's mental health law have a limited effect on decreasing rates of involuntary hospitalization?International journal of mental health systems · 2022Article
- Factors Affecting Treatment Regress and Progress in Forensic Psychiatry: A Thematic Analysis.Frontiers in psychiatry · 2022Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesIt has been suggested that since 1990, de-institutionalisation of mental healthcare in Western Europe has been reversed into re-institutionalisation with more forensic beds, places in protected housing services and people with mental disorders in prisons. This study aimed to identify changes in the numbers of places in built institutions providing mental healthcare in Western Europe from 1990 to 2012, and to explore the association between changes in psychiatric bed numbers and changes in other institutions. SETTINGS AND DATA: Data were identified from 11 countries on psychiatric hospital beds, forensic beds, protected housing places and prison populations. Fixed effects regression models tested the associations between psychiatric hospital beds with other institutions.
resultsThe number of psychiatric hospital beds decreased, while forensic beds, places in protected housing and prison populations increased. Overall, the number of reduced beds exceeded additional places in other institutions. There was no evidence for an association of changes in bed numbers with changes in forensic beds and protected housing places. Panel data regression analysis showed that changes in psychiatric bed numbers were negatively associated with rising prison populations, but the significant association disappeared once adjusted for gross domestic product as a potential covariate.
conclusionsInstitutional mental healthcare has substantially changed across Western Europe since 1990. There are ongoing overall trends of a decrease in the number of psychiatric hospital beds and an increase in the number of places in other institutions, including prisons. The exact association between these trends and their drivers remains unclear. More reliable data, information on the characteristics of patients in different institutions, long-term pathway analyses and effectiveness studies are required to arrive at evidence-based policies for the provision of institutional mental healthcare.
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