Arjan W Braam1, Omar W H R van Ommeren2, Melissa L van Buuren3, Wijnand Laan4, Hugo M Smeets4, Iris M Engelhard5. 1. Department of Emergency Psychiatry and Department of Specialist Training, Altrecht Mental Health Care, Utrecht, The Netherlands. 2. Faculty of Social Sciences, Department of Psychology, Utrecht University, Utrecht, The Netherlands; Palier Forensic Psychiatry, The Hague, The Netherlands. 3. Faculty of Social Sciences, Department of Psychology, Utrecht University, Utrecht, The Netherlands; Psychologiepraktijk Van Buuren, Barneveld, The Netherlands. 4. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. 5. Department of Emergency Psychiatry and Department of Specialist Training, Altrecht Mental Health Care, Utrecht, The Netherlands; Faculty of Social Sciences, Department of Psychology, Utrecht University, Utrecht, The Netherlands.
Abstract
BACKGROUND: Acute involuntary psychiatric admissions (AIPA) tend to be applied more often in urban areas. OBJECTIVE: The current study aims to describe AIPA prevalence differences between the subdistricts in an urban area, and to identify which district characteristics are associated with a higher AIPA district density. METHODS: Information was collected on consecutive AIPAs over a 64-month period (2005-2010) in 49 subdistricts in and around the city of Utrecht, the Netherlands, including 1098 AIPAs. District characteristics included several demographic and economical factors and health care characteristics such as number of sheltered living facilities. RESULTS: The AIPA density (mean 4.4/10,000 inhabitants/y) was four to five times higher in the most urbanized subdistrict (around 12) compared to the suburban subdistricts (2.5-3). On the district level, the main correlates with AIPA density per district were unemployment rate and small household size. Other correlates were percentage of non-Western immigrants and number of facilities of sheltered living. CONCLUSIONS: The considerable AIPA density variation between subdistricts in this urban environment reflects that people who are prone to psychiatric admissions live in economically less prosperous environments. Impaired social networks and economic concerns may also contribute to an environment representing social defeat, increased demoralization, or social fragmentation.
BACKGROUND: Acute involuntary psychiatric admissions (AIPA) tend to be applied more often in urban areas. OBJECTIVE: The current study aims to describe AIPA prevalence differences between the subdistricts in an urban area, and to identify which district characteristics are associated with a higher AIPA district density. METHODS: Information was collected on consecutive AIPAs over a 64-month period (2005-2010) in 49 subdistricts in and around the city of Utrecht, the Netherlands, including 1098 AIPAs. District characteristics included several demographic and economical factors and health care characteristics such as number of sheltered living facilities. RESULTS: The AIPA density (mean 4.4/10,000 inhabitants/y) was four to five times higher in the most urbanized subdistrict (around 12) compared to the suburban subdistricts (2.5-3). On the district level, the main correlates with AIPA density per district were unemployment rate and small household size. Other correlates were percentage of non-Western immigrants and number of facilities of sheltered living. CONCLUSIONS: The considerable AIPA density variation between subdistricts in this urban environment reflects that people who are prone to psychiatric admissions live in economically less prosperous environments. Impaired social networks and economic concerns may also contribute to an environment representing social defeat, increased demoralization, or social fragmentation.
Authors: Georgios Schoretsanitis; Sarah Eisenhardt; Meret E Ricklin; David S Srivastava; Sebastian Walther; Aristomenis Exadaktylos Journal: Int J Environ Res Public Health Date: 2018-06-21 Impact factor: 3.390