The rationing of psychiatric beds: changing trends in sex-ratios in admission to psychiatric hospital

Abstract

Admissions to psychiatric hospital for women have outnumbered those of men throughout most of this century. This paper presents data suggesting that recently there has been a shift in this overrepresentation. From the early 1980s there has been a downward trend in the extent to which women outnumber men in admissions to psychiatric in-patient treatment. This shift towards a greater representation of men in admission data has led to the position where, by 1986, in some age groups -particularly amongst young adults -men now outnumber women in admissions to psychiatric hospital. Possible explanations for this trend include a reduction in the availability of psychiatric beds together with an increasing emphasis on community care during the 1980s. Community care may be used more often in response to the treatment needs of women rather than men, or psychiatric beds may be seen as a scarce resource and more frequently reserved for men rather than for women. The paper explores changing patterns of both total admissions and first admissions from the 1960s. The rates of admission by sex and diagnostic group suggest possible explanations. In particular differences in the trend in admissions for each sex for schizophrenia require further analysis. The conclusion is that figures that indicate an increased tendency to hospitalize young men for psychotic illness in comparison with earlier years and in comparison with female risks of admission, may reflect changing patterns of disease, changes in patterns of treatment which are sexspecific, or more widespread changes in the lives of young men. However, the picture is complex and further research is needed.

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