International research indicates that delayed discharges from inpatient mental health units are common and most occur because patients lack suitable housing. However, little is known about this issue in an Australian setting. This mixed-methods study aimed to investigate the extent, cost and contributors to housing-related delayed discharge (HRDD) from inpatient mental health units in one Local Health District in New South Wales, Australia. A medical records review was conducted to quantify housing-related delay and housing difficulties noted. Perceptions of discharge staff about the factors contributing to the delays were gathered through in-depth interviews and analysed using constant comparative analysis. Findings indicated that HRDD for working aged adults accounted for 11.6% of total mental health bed days in 2018, costing the health system $4,054,149. When extrapolated nationally HRDD could cost Australia $269.5 million per year. While individual characteristics and contexts were thought to make some patients more vulnerable, data indicated that the major contributors were lack of housing options, lack of services, difficulty with funding and lack of clear pathways to achieve housing. The findings highlight the urgent need for additional housing for people with mental health issues and a whole of government approach to addressing the substantial issue of housing-related delayed discharge.

中文翻译：

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住院精神卫生单位与住房相关的延迟出院：大都市精神卫生服务的规模和贡献者

国际研究表明，住院精神卫生单位延迟出院很常见，而且大多数发生是因为患者缺乏合适的住所。然而，在澳大利亚的环境中对这个问题知之甚少。这项混合方法研究旨在调查澳大利亚新南威尔士州一个地方卫生区的住院精神卫生单位与住房相关延迟出院 (HRDD) 的程度、成本和原因。进行了医疗记录审查，以量化与住房相关的延误和住房困难。通过深入访谈收集出院人员对导致延误的因素的看法，并通过持续比较分析进行分析。调查结果表明，2018 年在职老年人的 HRDD 占心理健康床位总数的 11.6%，花费了卫生系统 4,054,149 美元。如果在全国范围内推断，HRDD 每年可能花费澳大利亚 2.695 亿美元。虽然个人特征和背景被认为使一些患者更容易受到伤害，但数据表明，主要原因是缺乏住房选择、缺乏服务、资金困难以及缺乏获得住房的明确途径。调查结果强调了为有心理健康问题的人提供额外住房的迫切需要，以及解决与住房相关的延迟出院这一重大问题的整个政府方法。缺乏服务、资金困难以及缺乏实现住房的明确途径。调查结果强调了为有心理健康问题的人提供额外住房的迫切需要，以及解决与住房相关的延迟出院这一重大问题的整个政府方法。缺乏服务、资金困难以及缺乏实现住房的明确途径。调查结果强调了为有心理健康问题的人提供额外住房的迫切需要，以及解决与住房相关的延迟出院这一重大问题的整个政府方法。