Social deprivation and the use of secure psychiatric beds

The objective of this study was to identify population-based characteristics that can predict and explain variations in secure psychiatric bed use at health authority level in England. Variables that characterize differences between health authority areas were first identified using factor analysis. A subset of these was then used in multiple regression analysis to predict variations in total secure bed days. A measure of the supply of supported housing was also entered into the model. Four-fifths of variation could be explained by Black ethnicity, Asian ethnicity, population density, number of people aged over 65, number of people single/widowed/divorced, number of people registered as permanently sick, and number of new registrations of drug use. The fit of the model was particularly good in inner London and other urban areas, but poorer in rural and 'maturer' areas. The addition of supported housing significantly increased the variation explained. Population-based data can be used to explain much of the variation in secure bed use, although the model is less satisfactory for non-urban areas. The supply of supported housing is associated with greater secure bed use.