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A 25-year dynamic ecological analysis of psychiatric hospital admissions and prison committals: Penrose’s hypothesis updated

Published online by Cambridge University Press:  15 November 2018

C. J. O’Neill ,
B. D. Kelly Open the ORCID record for B. D. Kelly [Opens in a new window]  and
H. G. Kennedy
C. J. O’Neill
Affiliation:
National Forensic Mental Health Service, Central Mental Hospital, Dundrum Road, Dublin 14, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, D14 W0V6, Ireland
B. D. Kelly
Affiliation:
Department of Psychiatry, Tallaght University Hospital, Tallaght, Trinity Centre for Health Sciences, Trinity College Dublin, The University of Dublin, D24 NR0A, Ireland
H. G. Kennedy*
Affiliation:
National Forensic Mental Health Service, Central Mental Hospital, Dundrum Road, Dublin 14, Trinity College Dublin, The University of Dublin, College Green, Dublin 2, D14 W0V6, Ireland
*
*Address for correspondence: Professor H. G. Kennedy, National Forensic Mental Health Service, Central Mental Hospital, Dundrum Road, Dublin 14, D14 W0V6, Ireland (Email: kennedh@tcd.ie)
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Abstract

Aims

There is renewed interest in the inverse association between psychiatric hospital and prison places, with reciprocal time trends shown in more than one country. We hypothesised that the numbers of admissions to psychiatric hospitals and committals to prisons in Ireland would also correlate inversely over time (i.e. dynamic measures of admission and committal rather than static, cross-sectional numbers of places).

Method

Publicly available activity statistics for psychiatric hospitals and prisons in Ireland were collated from 1986 to 2010.

Results

There was a reciprocal association between psychiatric admissions and prison committals (Pearson r=−0.788, p<0.001), an increase of 91 prison committals for every 100 psychiatric hospital admissions foregone.

Conclusion

Penrose’s hypothesis applies to admissions to psychiatric hospitals and prisons in Ireland over time (dynamic measures), just as it does to the numbers of places in psychiatric hospitals and prisons in Ireland and elsewhere (static, cross-sectional measures). Although no causal connection can be definitively established yet, mentally disordered prisoners are usually known to community mental health services. Psychiatric services for prisons and the community should be linked to ensure that the needs of those currently accessing care through prisons can also be met in the community.

Keywords

Hospitalspsychiatricprisonsmental disorderspatient admissionsubstance-related disordersIreland
Type
Short Report
Information
Irish Journal of Psychological Medicine , Volume 38 , Issue 3 , September 2021 , pp. 182 - 185
Copyright
© College of Psychiatrists of Ireland 2018

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