Prolonged hospitalization of persons with mental disorders in state-funded tertiary care psychiatric hospitals and unaccounted public health implications

Introduction: National strategy for an inclusive and community-based living (NSCIL) for persons with mental health issues 2019 report informs us that the length of stay (LOS) of 36% of inpatients in 43 state-funded tertiary care psychiatric hospitals (TCPHs) is above one year. This is concerning and its public health implications are not studied. Objectives: This study was carried out to estimate the average duration of hospitalization by persons with prolonged hospitalization (PPH) in TCPH and to estimate the number of additional inpatient admissions that could have been offered. Methodology: We analyzed the data in NSICL for calculating cumulative hospitalization years and the mean duration of stay by all PPH under each state. Based on the presumption that each psychiatric bed could cater to at least four admissions, a prediction is made on the number of additional inpatient admissions that could have been offered. Results: The mean duration LOS of 4869 people in these TCPHs is 9.6 years (range 1 – more than 25 years) with significant variation between the states. An additional 190,153 persons could have been offered inpatient care in these TCPHs over 25 years duration, and a minimum of 7606 additional admissions could be accommodated every year. Conclusions: Our predictions suggest a need for research on the possibility of deferred inpatient care to others with acute mental health needs and the scope for inpatient care to as many as in need by unblocking these beds.