Long-term hospital treatment: a 25-year study.

Findings from a 25-year study of admissions to a single long-term private psychiatric inpatient facility document a sharp decline in average age and an increase in concurrent diagnoses of substance abuse and personality disorders. In this case, long-term private inpatient care has survived the significant changes in mental health policy and funding practices of the past quarter century, but has shifted its focus from a more general psychiatric caseload to the seriously disturbed adolescent or young adult patient. There are numerous factors which determine every aspect of hospital treatment.

The long-term hospital treatment of the young chronic patient: follow-up findings.

A follow-up of sixty young-adult psychiatric patients hospitalized at least six months revealed that, at one to three years post-discharge, 83 percent were living in the community. Nearly two-thirds of the 60 patients were actively involved in aftercare treatment. A method of categorizing outcome based on overall level of functioning revealed that good outcomes occurred even among patients whose prognoses, based on treatment history and diagnosis, might be considered guarded.

Nicotine addiction in the psychiatric hospital: final report.

The following facts are now accepted by everyone with any sense of objectivity. One, that there is an entity known as nicotine addiction and that smoking is such an addiction. Two, that this addiction is related to more preventable deaths than any other disease in the United States.

Young chronic patients and substance abuse.

The prevalence of substance abuse was investigated in 100 young chronic patients consecutively admitted to a long-term private psychiatric hospital. Data were obtained from diagnostic research interviews with each subject at admission. Half of the subjects had concurrent diagnoses of psychiatric disorder and substance abuse.

Commentary: coping with nicotine addiction in the psychiatric hospital.

Smoking is an all too common practice. Mounting evidence compels us to see it as an addiction rather than the habit we have conveniently called it. The injurious effect smoking has on the health and life span of hundreds of thousands of people annually is unquestioned.

Cultural aspects of the psychiatric hospital.

How a psychiatric hospital may be viewed will depend on how its professionals think about the origins and treatment of the mental disorders. If the illness is considered physical in origin, the hospital dealing with it will give medications and apply physical methods of therapy with the aim of discharging the patient rapidly. If one regards the mental disorder as having social origins the institution will deal with its social factors as important to the therapeutic process.

A review of issues surrounding length of psychiatric hospitalization.

Recent emphasis on cutting the costs of psychiatric care and the possibility that reimbursement for psychiatric services will one day be based on diagnosis-related groups has stimulated debate about the proper length of psychiatric hospitalization. The authors review the literature on length of stay, focusing primarily on studies of the relationship between various patient and environmental variables and length of stay and studies comparing the outcomes of long and short hospitalizations. They conclude that diagnosis alone is not an accurate predictor of length of stay but may have predictive ability when combined with other data.

Toward the ideal state mental hospital: the human equation.

This paper gives the historical sketch necessary for an understanding of the current state of American psychiatry. It reviews some of the reasons why the rendering of good hospital care must be reconsidered, and describes some of the main features of the future public institution.

The socially-oriented psychiatric hospital.

The programs of psychiatric hospitals illustrate the differences we have about the origins and treatment of mental illness. They reflect the conflicts which divide us into camps. Most hospitals today are biologically oriented and their programs are short-term in nature.

Future of the chronic schizophrenic patient: prediction and recommendations.

A glimpse into the future for the schizophrenic patient requires a grasp of the history of American psychiatry and the many factors which led to the deinstitutionalization process and its negative effects. The paper reviews this material in some depth. It covers in detail the past forty years of legislation which saw psychiatry rise to heights of good care and then slowly decline to its present state.

The young adult chronic inpatient: research with a different perspective.

Young adult chronic patients have become an increasingly difficult population for the psychiatric hospital to treat. These patients are also now of mounting concern to public officials and those who must deal with them in the community. The reports on treatment for these patients emanating from the public sector are far from encouraging.

Build a better state hospital: deinstitutionalization has failed.

The author cites increasing numbers of chronic, homeless, and neglected mentally ill people as evidence of the failure of deinstitutionalization and community care to live up to their promise to reduce chronicity, the need for long-term hospitalization, and even mental illness itself. He believes the state hospital system, despite having been maligned and nearly destroyed, has great therapeutic potential. It could provide extended care to acutely ill patients before they become chronically ill; restore the ability to pinpoint responsibility for patient care, which has been lost under community care; and provide a stimulating academic environment conducive to research into treatment of the mentally ill.

The young adult chronic patient: review and critique of the literature.

The deinstitutionalization movement has given rise to an increasing number of young adult chronic patients in the community, a situation that poses a serious problem for both psychiatry and society. It invites a reassessment of both the policy of keeping patients in the community and the manner in which it has been managed up to this point. In recent years, a number of articles dealing with the young adult chronic patient have appeared.