Skip to main content Accessibility help

Community Care: Does it Reduce the Need for Psychiatric Beds? a Comparison of Two Different Styles of Service in Three Hospitals

  • R. E. Lawrence (a1), J. B. Copas (a2) and P. W. Cooper (a3)


The admission pattern of under-65s during the first seven years of Kidderminster's District General Hospital Psychiatric Department was compared with the last seven years of the mental hospital (Powick Hospital) which it superseded in July 1978, and with its nearest mental hospital (Barnsley Hall Hospital). In Kidderminster the average length of patient's hospital stay was half that at Barnsley Hall. There were more admissions per head of population, more which lasted less than a week, and more patients with over six admissions to Kidderminster than Barnsley Hall. The retrospective comparison with Powick Hospital showed that these differences were not due to the superior community facilities in Kidderminster since there was no real change in hospital bed use with the development of community services; this supports the view that there is a bed-rock of illness which will always need in-patient care however comprehensive the community resources.


Corresponding author

St Thomas' Hospital, Lambeth Palace Road, London


Hide All
Baker, A. A., (1969) Psychiatric unit in a district general hospital. Lancet, i, 10901092.
Bouras, N., Tufnell, G., Brough, D. I., et al (1986) Model for the integration of of community psychiatry and primary care. Journal of the Royal College of General Practitioners, 6266.
Coates, D. B., Kendall, L. M., Maccurdy, E. A., et al (1976) Evaluating hospital and home treatment for psychiatric patients. Canada's Mental Health, 24, 2832.
Copas, J. B., Freeman-Brown, D. L. & Robin, A. A. (1971) Danger periods for suicide in patients under treatment. Psychological Medicine, 1, 400404.
Cumella, S., Lawrence, R. E. & Robertson, J. A. (1988) A study of the accumulation of long-stay patients in a general hospital psychiatric department. Health Trends, 20, 4851.
DHSS (1984) The Facilities and Services of Mental Illness and Mental Handicap Hospitals in England 1980—1981. London: Her Majesty's Stationery Office.
Fenton, F. R., Tessier, L. & Struening, E. L. (1979) Home versus hospital care: One year follow-up. Archives of General Psychiatry, 36, 10731079.
Fenton, F. R., Tessier, L. & Struening, E. L. et al. (1982a) Home and Hospital Psychiatric Treatment. London: Croom Helm.
Fenton, F. R., Tessier, L. Contandriopoloulos, A. P., et al (1982b) Home vs hospital psychiatric treatment: Financial costs. Canadian Journal of Psychiatry, 27, 177187.
Fryers, T. (1974) Psychiatric inpatients in 1982: how many beds? Psychological Medicine, 4, 196211.
Fryers, T. (1979) Accumulating long-stay in-patients in Salford: monitoring further progress. Psychological Medicine, 9, 567572.
Grad, J. & Sainsbury, P. (1968) The effects patients have on their families in a community care and control psychiatric service: a two year follow up. British Journal of Psychiatry, 114, 265268.
Hafner, H. (1987) Do we still need beds for psychiatric patients. Acta Psychiatrica Scandanavica, 75, 113126
Hafner, H. & Heiden, W. (1989) The evaluation of mental health care systems. British Journal of Psychiatry, 155, 1217.
Hirsch, S. R. (1986) Psychiatric Beds and Resources: Factors Influencing Bed Use and an Approach to Service Planning. (Royal College of Psychiatry section for social and community psychiatry; Report of the Working Party on Bed Norms and Resources.) London: Gaskell.
Hoult, J., Reynolds, I., Charbonneau-Powis, M., et al (1983) Psychiatric hospital versus community treatment: a randomised trial. Australian and New Zealand Journal of Psychiatry, 17, 160167.
Hoult, J., Rosen, A., Reynolds, I. (1984) Community orientated treatment compared to psychiatric hospital orientated treatment. Social Science and Medicine, 18, 10051010.
Jarman, B. (1983) Identification of underprivileged areas. British Medical Journal, 286, 17051709.
Jarman, B. (1984) Validation and distribution of scores. British Medical Journal, 289, 15871592.
Kiesler, C. A. (1982) Mental health policy as a field for enquiry for psychology. American Psychologist, 35, 10661080.
Langsley, D. G., Pittman, F. S., Machotka, P., et al (1968) Family crisis therapy results and implications. Family Process, 7, 145158.
Lawrence, R. E., Cumella, S. & Robertson, J. A. (1988) Patterns of care in a district general psychiatric unit. British Journal of Psychiatry, 152, 188195.
Lehman, A. F. (1983) The well-being of chronic mental patients. Assessing their quality of life. Archives of General Psychiatry, 40, 369373.
Mann, S. A. & Cree, W. (1973) New long stay psychiatric patients. Psychological Medicine, 6, 603616.
Munk-Jorgensen, P. (1985) The schizophrenia diagnosis in Denmark. Acta Psychiatrica Scandanavica, 72, 266273.
Pasamanick, B., Scarpitt, F. & Dinitz, S. (1967) Schizophrenics in the Community: An Experimental Study in the Prevention of Hospitalisation. New York: Appleton-Century Crofts.
Polak, P. R. & Kirby, M. W. (1976) A model to replace psychiatric hospitals. Journal of Nervous and Mental Disease, 162, 1322.
Reynolds, I. & Hoult, J. E. (1984) Relatives of the mentally ill: A comparative trial of community orientated and hospital orientated psychiatric care. Journal of Nervous and Mental Disease, 172, 480489.
Stein, L. I. (1982) Community support systems for persons with chronic mental illness. New Directions for Mental Health Services, 14.
Stein, L. I. & Test, M. A. (1978) Alternatives to Mental Hospital Treatment. New York: Plenum Press Inc.
Stein, L. I. & Test, M. A. (1980) Alternative to mental hospital treatment. Archives of General Psychiatry, 37, 392397.
Stein, L. I. & Test, M. A. & Weisbrod, B. A. (1980) Alternative to mental hospital treatment. Archives of General Psychiatry, 37, 392405.
Stein, L. I. & Ganser, L. J. (1983) Wisconsin's system for funding mental health services. In Unified Health Systems: Utopia Unrealised (ed. Talbot, J. A.), pp. 2532. San Francisco: Jossey-Boss.
Tooth, G. C. & Brooke, E. M. (1961) Trends in the mental hospital population and their effect on future planning. Lancet, i, 710713.
Weeke, A., Kastrup, M. & Dupont, A. (1979) Long-stay patients in Danish psychiatric hospitals. Psychological Medicine, 9, 551566.

Community Care: Does it Reduce the Need for Psychiatric Beds? a Comparison of Two Different Styles of Service in Three Hospitals

  • R. E. Lawrence (a1), J. B. Copas (a2) and P. W. Cooper (a3)


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Community Care: Does it Reduce the Need for Psychiatric Beds? a Comparison of Two Different Styles of Service in Three Hospitals

  • R. E. Lawrence (a1), J. B. Copas (a2) and P. W. Cooper (a3)
Submit a response


We encountered an error trying to retrieve eLetters for this article. Please try again or contact Customer Services


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *