Have general hospitals become chronic care institutions for the mentally ill?

Article Abstract:

General hospital psychiatry services have been strained by the need to treat deinstitutionalized mentally ill patients who have been offered inadequate community services. There has also been a rise in homelessness and drug abuse among the mentally ill. If there is a trend toward shifting the responsibility for this population away from state hospitals by having the general hospitals pick up the slack in the care of the chronic mentally ill, it is important to make note of this trend and to identify the factors leading to its development. Changes in utilization patterns and patient characteristics were examined in community hospitals in New York City. From 1985 to 1988, discharges to long-term care increased from 6 percent to 10 percent and represented a near-doubling of the number of patients discharged to state psychiatric facilities. The number of psychiatric patients readmitted to the same facility at least once during a year increased by 9 percent. Of the patients who were chronic, as determined by their long stays, repeated admissions, and discharge to long-term care, 63 percent were schizophrenic or suffered from organic brain disorders. Medical illness was found as well in about half the patients. It appears that the number of patients with short stays has decreased while the number of patients with long stays has increased, and readmission rates have increased as well. This is consistent with the use of general hospital psychiatric units for chronic care. Some argue that increased availability of appropriate housing would lessen the burden, and others feel that deinstitutionalization has released a poorly functioning group of people to the streets. The treatment needs of these people must be better defined so that an appropriate mix of services and reimbursement structures can be implemented. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Evaluation, Mentally ill persons, Mentally ill, Institutional care, Psychiatric hospital care, Psychiatric hospitals

---

The future of psychiatry: psychiatrists of the future

Article Abstract:

Theoretical developments and scientific advances in diagnosis and treatment are the foci of most discussions about the future of psychiatry. A notably absent topic in these discussions, however, is the issue of manpower with regard to both psychiatrists in practice and those in training. For those in practice, continuing education programs are necessary and need to be planned. For those in training, education needs to be attended to. For both, the changing face of the field needs to be considered so that future patient-care needs and research needs can be adequately met. Census data regarding psychiatric residents in training obtained from the American Psychiatric Association (APA) Office of Membership were reviewed. Over the past 10 years there has been a 25 percent increase in the number of psychiatric residents in the United States. The proportion of women has increased from 32 percent to 41 percent in the same period, with the largest percentage of women (35 percent) being in the under-35 age group. As a result of these changes and the disproportionate increase in the number of women as compared with men entering medicine in general and the specialty of psychiatry, gender differences that have existed in the past will change. These changes are important to consider in planning for future needs in research and patient care. (Consumer Summary produced by Reliance Medical Information, Inc.)

Demographic aspects, Training, Study and teaching, Mental illness, Mental disorders, Psychiatrists, Psychiatry

---

Similar abstracts:

• Abstracts: Frequency, probability, and prediction: easy solutions to cognitive illusions? Collaborative planning and prediction: does group discussion affect optimistic biases in time estimation?
• Abstracts: Mental capacity constraints and the development of moral reasoning
• Abstracts: Positive marital illusions: self-enhancement or relationship enhancement? Positive illusions about marriage among married and single individuals
• Abstracts: Will we save the homeless mentally ill? Diagnosis, guardianship, and residential care of the mentally ill in medieval and early modern England
• Abstracts: The natural history of alcohol abuse: implications for definitions of alcohol use disorders. The normalcy of self-proclaimed "normal volunteers"

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.