Community factors influencing psychiatric hospital utilization in rural and urban Ireland

Abstract

The role of community factors in psychiatric hospital utilization in rural and urban Ireland was evaluated using Hollingshead & Redlich's conceptual model. Rural and urban differences in identification of psychiatric disorders, attitude to psychiatric facilities and social isolation were assessed using a community survey (N = 200). No difference was found in the recognition of schizophrenic behavior. Rural residents tended to normalize neurotic behavior and significantly fewer recognized it as deviant. The two communities did not differ in the identification of alcoholism or neuroses as mental illness. Rural individuals had a more negative attitude to psychiatric facilities, and sought help more frequently from relatives who were less accessible than their urban counterparts.

Urbanisation and Psychiatric Admission Rates in the Netherlands

“…Urban and rural areas can differ in terms of attitudes to psychiatric help. Keatinge (1987) found that country residents had a more negative attitude towards psychiatric facilities. When they had psychiatric problems, they also turned to friends for help more often.…”

Admission rates for schizophrenia in The Netherlands: an urban/rural comparison

“…Admission rates are indeed related to true morbidity, but they are probably also influenced by referral patterns, helpseeking behaviour and distance from psychiatric facilities (14). For instance, Keatinge found that inhabitants of rural areas had a more negative attitude towards psychiatry than urban dwellers (15). Patients in rural areas were more often looked after by their families and friends.…”

Social indicators and psychiatric admission rates: a case-register study in the Netherlands

“…As Keatinge (1987) pointed out: 'There is a need, in particular, to examine the role of small towns in rural communities...'. The present study contributes to this need because it was a study undertaken in a rural area with only small towns.…”

“…In many studies a decline of admission rates in relation to the distance from mental-health facilities was found (Davey & Giles, 1979;Joseph & Boeckh, 1981;Richman et al 1984;Vaslamatzis et al 1987). Other studies report higher admission rates in urban areas (Keatinge, 1987). The problem is that both variables are closely related, since facilities are more often located in urban areas and therefore the distance to facilities will be small in these areas.…”