Reducing the revolving door phenomenon. 2010

Antoinette Daly, and Donna Tedstone Doherty, and Dermot Walsh
Mental Health Research Unit,Health Research Board,Knockmaun House,42-47 Lower Mount Street,Dublin 2,Ireland.

OBJECTIVE De-institutionalisation and the expansion of community services have resulted in a reduction in the number of inpatient admissions in Ireland having fallen by 31% between 1986 and 2006. However, despite this, readmissions continue to account for over 70% of all admissions. The policy document A Vision for Change identified many shortcomings in the current model of provision of mental health services, making recommendations for the future development of community-based services with emphasis on outreach components such as homecare, crisis intervention and assertive outreach approaches. These recommendations are reviewed in relation to readmissions and the impact they may have on reducing the revolving door phenomenon. METHODS Three main intervention programmes essential to the delivery of an effective community-based service outlined and recommended by A Vision for Change, along with other pertinent factors, are discussed in relation to how they might reduce readmissions in Ireland. A series of Pearson correlations between Irish inpatient admissions rates and rates of outpatient attendances and provision of community mental health services are carried out and examined to explain possible relationships between increasing/decreasing admission rates and provision/attendances at community services. International literature is reviewed to determine the effectiveness of these intervention programmes in reducing admissions and readmissions and their relevance to the Irish situation is discussed. CONCLUSIONS Whilst A Vision for Change goes a long way towards advocating a more person-centred, recovery oriented and integrated model of service delivery, it is apparent from the consistently high proportion of readmissions in Ireland that there are still many shortcomings in service provision. The availability of specialised community-based programmes of care is as yet relatively uncommon in Ireland and uneven in geographical distribution. A considerable improvement in their provision, quantitatively and qualitatively, is required to impact on the revolving door phenomenon. In addition a re-configuration of existing catchment populations is required if they are to be successfully introduced and expanded.

UI MeSH Term Description Entries

Related Publications

Antoinette Daly, and Donna Tedstone Doherty, and Dermot Walsh
November 1996, The American journal of psychiatry,
Antoinette Daly, and Donna Tedstone Doherty, and Dermot Walsh
January 2011, The American nurse,
Antoinette Daly, and Donna Tedstone Doherty, and Dermot Walsh
January 1975, MH,
Antoinette Daly, and Donna Tedstone Doherty, and Dermot Walsh
May 1981, The Journal of nervous and mental disease,
Antoinette Daly, and Donna Tedstone Doherty, and Dermot Walsh
August 2023, The International journal of social psychiatry,
Antoinette Daly, and Donna Tedstone Doherty, and Dermot Walsh
March 1979, Family health,
Antoinette Daly, and Donna Tedstone Doherty, and Dermot Walsh
June 2008, JEMS : a journal of emergency medical services,
Antoinette Daly, and Donna Tedstone Doherty, and Dermot Walsh
January 2012, Nursing standard (Royal College of Nursing (Great Britain) : 1987),
Antoinette Daly, and Donna Tedstone Doherty, and Dermot Walsh
December 2016, Physical therapy,
Antoinette Daly, and Donna Tedstone Doherty, and Dermot Walsh
February 1998, Science (New York, N.Y.),
Copied contents to your clipboard!