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Patterns of Care in a District General Hospital Psychiatric Department

Published online by Cambridge University Press:  02 January 2018

R. E. Lawrence ,
S. Cumella  and
J. A. Robertson
R. E. Lawrence*
Affiliation:
University of Birmingham
S. Cumella
Affiliation:
Mental Health Unit, Central Birmingham Health Authority
J. A. Robertson
Affiliation:
Kidderminster District General Hospital, Bewdley Road, Kidderminster
*
∗Department of Psychiatry, University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT
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Abstract

A survey of all admissions of patients under the age of 65 during the first 6 years of a District General Psychiatric Department without mental-hospital support is reported. Three high-uptake groups of in-patients were defined; the long-stay (12 months or more), the medium-stay (6–12 months), and the revolving-door group (more than three admissions in any period of 12 months). Identifying characteristics which distinguish between these groups were examined. During a 7-year period there was no accumulation of long-stay patients, and a striking lack of schizophrenic patients who remained in hospital for more than 6 months or who had more than three admissions in any twelve-month period. This was not accounted for by drift of the high-uptake groups out of contact with the service, but may be related both to the style of service provision and to the socially cohesive nature of the area under study. Local variation should be given due importance when community services are being developed.

Type
Research Article
Information
The British Journal of Psychiatry , Volume 152 , Issue 2 , February 1988 , pp. 188 - 195
Copyright
Copyright © Royal College of Psychiatrists, 1988 

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References

American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn) (DSM-III). Washington, DC: APA.Google Scholar
Babker, I. E. (1980) Social and clinical correlates of the ‘new’ long stay. Acta Psychiatrica Scandinavica, 61, 365–375.CrossRefGoogle Scholar
Bachrach, L. L. (1982) Assessment of outcome in the community. Support systems; results, problems and limitations. Schizophrenia Bulletin, 8, 39–51.Google Scholar
Bennett, D. (1978) Community psychiatry. British Journal of Psychiatry, 132, 209–220.Google Scholar
Braun, P., Kochansky, G., Shapiro, R., Greenberg, S., Sudeman, J. E., Johnson, S. & Shore, M. F. (1981) Overview of the de-institutionalization of psychiatric patients; a critical review of outcome studies. American Journal of Psychiatry, 136, 736–749.Google Scholar
Caton, C. L. M. (1981) The new chronic patient and the system of community care. Hospital and Community Psychiatry, 32, 475–478.Google Scholar
Crabtree, L. H. Jnr (1984) Disability in young adult chronic patients at discharge from a private psychiatric hospital. New Direction in Mental Health Services, 21, 37–47.CrossRefGoogle Scholar
Cumella, S. (1986) Summary of conclusions: a longitudinal study of the accumulation of long-stay patients in a general hospital psychiatric department. Research Policy and Planning, Research Digest, 142, 49–50.Google Scholar
Department Of Health And Social Security (1985) Inpatient Statistics from the Mental Health Enquiry for England 1982. London: HMSO.Google Scholar
Ebringer, L. & Brown, C. J. R. W. (1980) Social deprivation among short stay psychiatric patients. British Journal of Psychiatry, 136, 46–52.Google Scholar
Freeman, H. L., Cheadle, A. J. & Korer, J. R. (1979) Use of hospital services by chronic schizophrenics in the community. British Journal of Psychiatry, 134, 417–421.Google Scholar
Freeman, H. L., & Choudhury, M. H. P. (1984), Social characteristics of newly admitted mental hospital patients – a replication study. Health Trends, 16, 55–57.Google Scholar
Grad, J. & Sainsbury, P. (1968) The effects that patients have on their families in a community care and control psychiatric service. A two year follow up, British Journal of Psychiatry, 114, 265–278.Google Scholar
Graig, T. J. Goodman, A. B., Seigle, C., & Wanderling, J. (1984) The dynamics of hospitalization in a defined population during de-institutionalization. American Journal of Psychiatry, 141, 782–785.Google Scholar
Hafner, H. & Klug, J. (1982) The impact of an expanding community mental health service on patterns of bed usage; evaluation of a four-year pattern of implementation. Psychological Medicine, 12, 177–190.CrossRefGoogle Scholar
Harris, M. & Bergman, H. D. (1984) The young adult chronic patient; affective responses to treatment. New Direction in Mental Health Services, 21, 29–35.Google Scholar
Hirsch, S. R. (1988) Psychiatric beds and resources: factors influencing bed use and service planning. London: Royal College of Psychiatrists.Google Scholar
Inter-register Technical Committee (1984) Psychiatric Care in Eight Register Areas. Statistics from Eight Psychiatric Case Registers in Great Britain. 1976–81. Southampton: University of Southampton Press.Google Scholar
Jarman, B. (1983) Identification of underprivileged areas. British Medical Journal, 268, 1705–1709.Google Scholar
Jarman, B. (1984) Validation and distribution of scores. British Medical Journal, 289, 1587–1592.CrossRefGoogle ScholarPubMed
Klein, J. (1983) The least restrictive alternative; more about less. Psychiatric Quarterly, 55, 106–114.Google Scholar
Leff, J. P. (1982) Chronic syndromes of schizophrenia. In Handbook of Psychiatry 3 (eds Wing, J. K. and Wing, L.). Cambridge: Cambridge University Press.Google Scholar
Levene, L. S., Donaldson, L. T. & Brandon, S. (1985) How likely is it that a district health authority can close its large mental hospitals? British Journal of Psychiatry, 147, 150–155.CrossRefGoogle ScholarPubMed
Mann, S. A. & Cree, W. (1976) New long stay psychiatric patients. Psychological Medicine, 6, 603–616.Google Scholar
Stein, L. J. & Test, M. A. (1979) Alternative to mental hospital treatment; conceptual model, treatment programme and clinical evaluation. Archives of General Psychiatry, 37, 392–397.Google Scholar
Test, M. A. & Stein, L. J. (1978) Community treatment of the chronic patient; research overview. Schizophrenia Bulletin, 4, 350–364.Google Scholar
Torre, E., Marinoni, A. & Allegri, G. (1982) Lomest psychiatric case register; old and new long stay patients. Social Psychiatry, 17, 125–182.Google Scholar
Towell, D. & McAusland, T. (1984) Managing Psychiatric Services in Transition. London: Kings Fund.Google Scholar
Whitmer, G. (1980) From hospitals to jails; the fate of California's de-institutionalized mentally ill. American Journal of Orthopsychiatry, 50, 65–76.Google Scholar
Wing, J. K. (1982) From institutional to community care. Psychiatric Quarterly, 53, 139–152.Google Scholar
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