Social Psychiatry and Psychiatric Epidemiology

, Volume 51, Issue 9, pp 1285–1291 | Cite as

An assessment of need for mental health rehabilitation amongst in-patients in a Welsh region

  • Tony RyanEmail author
  • John Carden
  • Robert Higgo
  • Rob Poole
  • Catherine A. Robinson
Original Paper



Rehabilitation services have received little attention in the literature compared with other types of mental health service provision over the past 15 years. However, they are an important component of whole-system functioning in mental health services. Lack of provision has a particular impact on acute in-patient services. Poor pathway management can result in delayed discharges, placement of service users far from home, and resultant loss of resource for the local mental health economy.


A cross-sectional study gathered demographic, clinical, service utilisation, and financial data on 100 participants from out of area, rehabilitation and acute mental health units. Financial data was provided by the Health Board. Other data were gathered by two clinicians from case records and staff interviews.


26.0 % of people were inappropriately placed, with frequent overprovision of support. It was calculated that within an annual budget of £12.7 M, £2.5 M (19.7 % of the total expenditure on this patient group) could be saved if all placements were appropriate.


There were differences between the three cohorts. Those placed out of area had the most complex needs, although those in rehabilitation placements were similar. Most participants had been in contact with services for more than 5 years. A system better matched to their needs would benefit these patients and would also generate financial savings for reinvestment in the mental health economy.


Rehabilitation Needs assessment Service redesign Commissioning Out of area treatments 


Compliance with ethical standards


This work was funded by Public Health Wales and the Local Health Board.

Conflict of interest

There are no conflicts of interest.

Supplementary material

127_2016_1213_MOESM1_ESM.doc (71 kb)
Supplementary material 1 (DOC 71 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Tony Ryan
    • 1
    • 3
    Email author
  • John Carden
    • 2
    • 3
  • Robert Higgo
    • 2
    • 3
  • Rob Poole
    • 2
    • 3
  • Catherine A. Robinson
    • 3
  1. 1.Tony Ryan AssociatesManchesterUK
  2. 2.Betsi Cadwaladr University Health BoardWrexhamUK
  3. 3.Centre for Mental Health and SocietyBangor UniversityBangorUK

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