{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:58:33Z","timestamp":1785391113439,"version":"3.55.0"},"reference-count":18,"publisher":"BMJ","issue":"7076","license":[{"start":{"date-parts":[[1997,1,25]],"date-time":"1997-01-25T00:00:00Z","timestamp":854150400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[1996,12,6]]},"published-print":{"date-parts":[[1997,1,25]]},"abstract":"Abstract<\/jats:title>\n \n Objectives:<\/jats:bold>\n To examine the relation between bed use, social deprivation, and overall bed availability in acute adult psychiatric units and to explore the range of alternative residential options.\n <\/jats:p>\n \n Design:<\/jats:bold>\n Cross sectional survey, combined with one day census data; ratings by and interviews with staff; examination of routine data sources.\n <\/jats:p>\n \n Settings:<\/jats:bold>\n Nationally representative sample of acute psychiatric units.\n <\/jats:p>\n \n Subjects:<\/jats:bold>\n 2236 patients who were inpatients on census day.\n <\/jats:p>\n \n Main outcome measures:<\/jats:bold>\n Bed occupancy levels, judged need for continuing inpatient care, reasons preventing discharge, scores on the Health of the Nation outcome scales.\n <\/jats:p>\n \n Results:<\/jats:bold>\n Bed occupancy was related to social deprivation and total availability of acute beds (\n r<\/jats:italic>\n =0.66, 95% confidence interval 0.19 to 0.88, F=8.72, df=2, 23; P=0.002). However, 27% (603\/2215) of current inpatients (61% (90\/148) of those with stays of >6 months) were judged not to need continuing admission. The major reasons preventing discharge were lack of suitable accommodation (37% (176\/482) of patients in hospital <6 months\n v<\/jats:italic>\n 36% (31\/86) of those in hospital >6 months); inadequate domiciliary based community support (23% (113)\n v<\/jats:italic>\n 9% (8)); and lack of long term rehabilitation places (21% (100)\n v<\/jats:italic>\n 47% (40)). Scores on the Health of the Nation outcome scale were generally consistent with these staff judgments.\n <\/jats:p>\n \n Conclusions:<\/jats:bold>\n The shortage of beds in acute psychiatric units is related to both social deprivation and the overall availability of acute beds. Patients currently inappropriately placed on acute admission wards should be relocated into more suitable accommodation, either in hospital or in the community. A range of provisions is required; simply providing more acute beds is not the answer.\n <\/jats:p>\n \n \n \n Key messages<\/jats:title>\n \n \n This study shows that there is a shortage of acute psychiatric beds and that this is related to both social deprivation and the overall availability of beds<\/jats:p>\n <\/jats:list-item>\n \n Over a quarter of inpatients were considered to be inappropriately placed on admission wards\u2013for those with lengths of stay of more than six months this figure increased to 61%<\/jats:p>\n <\/jats:list-item>\n \n Lack of suitable accommodation, home based support, and rehabilitation places was identified as the major reason preventing discharge<\/jats:p>\n <\/jats:list-item>\n \n A range of hospital and community facilities is therefore required to address these problems of over-occupancy and shortages of acute beds<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>\n <\/jats:boxed-text>\n <\/jats:p>","DOI":"10.1136\/bmj.314.7076.262","type":"journal-article","created":{"date-parts":[[2011,10,27]],"date-time":"2011-10-27T19:45:02Z","timestamp":1319744702000},"page":"262","source":"Crossref","is-referenced-by-count":69,"title":["Relation between bed use, social deprivation, and overall bed availability in acute adult psychiatric units, and alternative residential options: a cross sectional survey, one day census data, and staff interviews"],"prefix":"10.1136","volume":"314","author":[{"given":"G","family":"Shepherd","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Beadsmoore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"Hardy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Muijen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[1997,1,25]]},"reference":[{"key":"2025122312540038000_314.7076.262.1","unstructured":"Department of Health. The Health of the Nation key area handbook. 2nd ed. London: HMSO, 1994."},{"key":"2025122312540038000_314.7076.262.2","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1192\/pb.19.5.273","article-title":"Resolving London's bed crisis: there might be a way, is there a will?","volume":"19","author":"Lelliot","year":"1995","journal-title":"Psychiatr Bull"},{"key":"2025122312540038000_314.7076.262.3","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1192\/pb.19.5.276","article-title":"Monitoring inner London mental illness services.","volume":"19","year":"1995","journal-title":"Psychiat Bull"},{"key":"2025122312540038000_314.7076.262.4","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1192\/pb.18.9.532","article-title":"\u00e2\u0080\u009cSorry no beds\u00e2\u0080\u009d: a problem for acute psychiatric admissions.","volume":"18","author":"Hollander","year":"1994","journal-title":"Psychiatr Bull"},{"key":"2025122312540038000_314.7076.262.5","doi-asserted-by":"publisher","DOI":"10.1192\/pb.18.9.531"},{"key":"2025122312540038000_314.7076.262.6","unstructured":"National Schizophrenia Fellowship. What's gone wrong? Surbiton: NSF Publications, 1994."},{"key":"2025122312540038000_314.7076.262.7","unstructured":"NHS Executive . 24 Hour nursed care for people with severe and enduring mental illness. Leeds: NHSE, 1996."},{"key":"2025122312540038000_314.7076.262.8","unstructured":"Audit Commission . Finding a place. A review of mental health services for adults. London: HMSO, 1994."},{"key":"2025122312540038000_314.7076.262.9","unstructured":"Clinical Standards Advisory Group. Report on standards of care for people with schizophrenia. London: HMSO, 1995."},{"key":"2025122312540038000_314.7076.262.10","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1136\/bmj.286.6379.1705","article-title":"Identification of underprivileged areas.","volume":"286","author":"Jarman","year":"1983","journal-title":"BMJ"},{"key":"2025122312540038000_314.7076.262.11","unstructured":"Curtis R Beevor A . Health of the nation outcome scales (HONOS). In: Wing J , ed. Measurement for mental health. London: Royal College of Psychiatry, 1995."},{"key":"2025122312540038000_314.7076.262.12","doi-asserted-by":"crossref","first-page":"335","DOI":"10.3109\/09638239208991563","article-title":"Challenging bed behaviours: the use of acute psychiatric beds in an inner London district health authority.","volume":"1","author":"Fulop","year":"1992","journal-title":"J Ment Health"},{"key":"2025122312540038000_314.7076.262.13","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.165.2.160"},{"key":"2025122312540038000_314.7076.262.14","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.168.4.448"},{"issue":"suppl 19","key":"2025122312540038000_314.7076.262.15","first-page":"1","article-title":"The TAPS project: evaluating community placement of long-stay psychiatric patients.","volume":"162","author":"Leff","year":"1993","journal-title":"Br J Psychiatry"},{"key":"2025122312540038000_314.7076.262.16","unstructured":"Muijen M . Mental health services: what works? In: Weller MP, Muijen M, eds. Dimensions of community care. London: Saunders, 1993."},{"key":"2025122312540038000_314.7076.262.17","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1176\/ps.46.7.669","article-title":"Assertive community treatment: an update of randomized controlled trials.","volume":"46","author":"Burns","year":"1995","journal-title":"Psychiatr Services"},{"key":"2025122312540038000_314.7076.262.18","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1080\/09638239619275","article-title":"Does intensive case management work? Clinical, social and quality of life outcomes from a controlled study","volume":"5","author":"Ford","year":"1996","journal-title":"J Ment Health"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.314.7076.262","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.314.7076.262","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T20:54:11Z","timestamp":1766523251000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.314.7076.262"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,1,25]]},"references-count":18,"journal-issue":{"issue":"7076","published-online":{"date-parts":[[1997,1,25]]},"published-print":{"date-parts":[[1997,1,25]]}},"alternative-id":["10.1136\/bmj.314.7076.262"],"URL":"https:\/\/doi.org\/10.1136\/bmj.314.7076.262","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"value":"0959-8138","type":"print"},{"value":"1468-5833","type":"electronic"}],"subject":[],"published":{"date-parts":[[1997,1,25]]}}}