Report provides new measures of health system performance for mental
OTTAWA, June 8, 2011 /CNW/ - In 2009-2010, approximately 17,500
Canadians— or 45 people a day—were admitted to hospital after
attempting suicide or deliberately harming themselves. When combined
with suicide deaths and emergency department visits, the estimated rate
of self-injury in Canada is higher than the hospitalized stroke rate,
according to a new report from the Canadian Institute for Health Information (CIHI).
Health Indicators 2011 shows that, in 2009-2010, about 140 Canadians per 100,000 were cared for
in an emergency department, admitted to a general hospital or died from
self-inflicted injuries, compared with 124 per 100,000 hospitalized
because of a stroke. The most common method of self-injury leading to
hospitalization was poisoning (85%), followed by cutting or piercing
(10%) and strangulation (2%).
Young women age 15 to 19 were the most likely to self-injure. Women in
this age group had a self-injury hospitalization rate of more than 140
per 100,000—more than double the rate of men in the same age category.
However, men were three times more likely to die from self-inflicted
injuries. In 2007, 16 per 100,000 men died from self-inflicted
injuries, compared with 5 per 100,000 women.
"Self-injury rates can be seen as an indicator of access to community
care," says Kira Leeb, Director, Health System Performance, at CIHI.
"While suicide and self-harming behaviours are very complex, they are
considered largely preventable when accessible and effective
community-based intervention strategies are in place. Information that
can help to better identify and understand what groups are most at risk
for self-injury can assist in the development of targeted prevention
Rates of self-injury varied across the country and were higher in the
territories than in the provinces. CIHI's report shows that for most
(70%) self-injury hospitalizations, the patient also had a diagnosis of
mental illness. Mood disorders accounted for almost one-quarter (23%)
of these diagnoses, followed by substance-related disorders (12%) and
anxiety disorders (11%).
Many mental health inpatients are readmitted shortly after discharge
CIHI's report also highlights performance measures for mental health
services. In 2009-2010, about one in nine (11.4%) hospitalizations for
a mental illness was followed by a readmission within 30 days of
discharge. For the purpose of this study, mental illness includes
anxiety disorders, mood disorders, personality disorders, schizophrenia
and substance-related disorders.
"Mental health-related indicators tell us not just about the use of
general hospital services, but about broader access to care and support
across the system," explains Chantai Couris, Senior Researcher, Health
System Performance, at CIHI. "Readmission rates, for example, are
measures of the coordination and continuity of mental health services.
Not all readmissions can be avoided, but ensuring that community
services are available for people after they leave the hospital may
help prevent the so-called revolving door of hospitalization for those
living with a mental illness."
Two out of five (41%) mental health readmissions occurred within 7 days,
and almost two-thirds (64%) took place within 14 days of discharge.
Readmission was more likely when the initial hospitalization was for
schizophrenia (13.2%) or a personality disorder (13.1%) than when it
was for an anxiety disorder (8.9%). In the regions where comprehensive
emergency department data was available, at least 70% of readmissions
were preceded by an emergency department visit.
CIHI's study also looks at the number of people who were hospitalized
three or more times a year for mental illness. In 2008-2009,
approximately one in nine (11%) mental health inpatients was
hospitalized three or more times within a 12-month period. These
patients accounted for 28% of all mental health hospitalizations and
27% of the total number of patient days.
"This focus on mental health-related indicators shows that there is an
opportunity to examine ways to improve the current mental health system
in Canada," says Carol Adair, Adjunct Associate Professor, Departments
of Psychiatry and Community Health Sciences, University of Calgary.
"Ensuring individuals have a smooth transition from the hospital to
effective community care and support will help them stay out of
hospital and reach a level of optimal mental health and quality of
About Health Indicators
CIHI's Health Indicators annual report, produced in partnership with Statistics Canada, presents
more than 40 comparable measures of health and health system
performance by health region, province and territory. For the first
time, this year's report features a focus section on mental health,
including new performance indicators that provide information about
Canada's mental health system. Examples of other indicators in the
report are heart and stroke performance measures, Caesarean section
rates and health status measures.
The report, as well as the following figures, is available on our
website at www.cihi.ca.
Age-Standardized Self-Injury Hospitalization Rate, by Province, Canada,
2009-2010 (Figure 2 in the report)
Self-Injury Hospitalization Rate, by Sex and Age Group, Canada,
2009-2010 (Figure 5 in the report)
Risk-Adjusted 30-Day Readmission Rates, by Type of Mental Illness,
Canada, 2009-2010 (Figure 7 in the report)
Age-Standardized Hospitalization Rates, by Type of Mental Illness,
Canada, 2009-2010 (Figure 13 in the report)
SOURCE CANADIAN INSTITUTE FOR HEALTH INFORMATION
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