Abstract
A retrospective longitudinal treatment utilization study of 56 young chronic schizophrenic patients who began their treatment careers during the deinstitutionalization era was carried out covering all psychiatric services provided to each patient since first treatment. The group was primarily male and was characterized by histories of drug abuse and violence. Treatment utilization was heavy, discontinuous, and episodic with these patterns intensified for patients with histories of drug abuse. The majority of the group became “long-stay” hospital residents. The clinical and mental health policy implications of these findings are discussed and further research is suggested.
Similar content being viewed by others
References
National Institute of Mental Health:Psychiatric services and the changing institutional scene, 1950–1955. (DHEW Publication No. (ADM) 77–433) Washington, DC, US Government Printing Office, 1977
Redlich F, Kellert SR: Trends in American mental health.Am J Psychiatry 135:22–28, 1978
Hailey AM: The new chronic psychiatric population.British Journal of Preventive and Social Medicine 28:180–186, 1974
Kedward MB: The hospital census as a sampling frame for studies of long-term psychiatric care.Psychiatr Q 48:535–542, 1974
Bachrach LL: Young adult chronic patients: an analytical review of the literature.Hosp Community Psychiatry 33:189–197, 1982
Rud J, Noreik K: Who become long-stay patients in a psychiatric hospital?Acta Psychiatr Scand 65:1–14, 1982
Serban G:Adjustment of Schizophrenics in the Community. New York, Spectrum, 1980
Segal SP, Baumohl J, Johnson E: Falling through the cracks: mental disorder and social margin in a young vagrant population.Social Problems 24:387–400, 1977
Reich R, Siegel R: The emergence of the Bowery as a psychiatric dumping ground.Psychiatr Q 50:191–201, 1978
Robbins E, Stern M, Robbins L,et al.: Unwelcome patients: where can they find asylum? Hosp Community Psychiatry 29:44–46, 1978
Bassuk EL: The impact of deinstitutionalization on the general hospital psychiatric emergency ward.Hosp Community Psychiatry 31:623–627, 1980
Gerson S, Bassuk E: Psychiatric emergencies: An overview.Am J Psychiatry 137:1–11, 1980
Segal SP, Baumohl J: Engaging the disengaged proposal on madness and vagrancy.Social Work 25:358–365, 1980
Pepper B, Kirshner MC, Ryglewicz H: The young adult chronic patient: overview of a population.Hosp Community Psychiatry 32:463–469, 1981
Schwartz SR, Goldfinger SM: The new chronic patient: clinical characteristics of an emerging subgroup.Hosp Community Psychiatry 32:470–474, 1981
Lamb HR: Young adult chronic patients, the new drifters.Hosp Community Psychiatry 33:465–468, 1982
Talbott JA: The emerging crisis in chronic care.Hosp Community Psychiatry 32:447, 1982
Shearn CR, Fitzgibbons DJ: Patterns of drug use in a population of youthful psychiatric patients.Am J Psychiatry 128:1381–1387, 1972
Hailey AM: Long-stay psychiatric inpatients: A study based on the Camberwell Register.Psychol Med 1:128–142, 1971
Wing JK, Hailey AM:Short and medium term hospital care, in Evaluating a Community Psychiatric Service. Edited by Wing JK, Hailey AM. London, Oxford University Press, 1972
Babiker IE: Social and clinical correlates of the “new” long-stay.Acta Psychiatr Scand 61:365–375, 1980
Cohen M, Klein DF: Drug abuse in a young psychiatric population.Am J Orthopsychiatry 46:448–455, 1970
Blumberg AG, Cohen M, Heaton AM,et al. Covert drug abuse among voluntary hospitalized psychiatric patients.JAMA 217:1659–1661, 1971
Breakey WR, Goodell H, Lorenz PC,et al.: Hallucinogenic drugs as precipitants of schizophrenia.Psychol Med 4:255–261, 1974
Razani J, Farina FA, Stern R: Covert drug abuse among patients hospitalized in the psychiatric ward of a university hospital.Int J Addict 10:693–698, 1975
Tardiff K, Sweillam A: Characteristics of violent patients admitted to public hospitals.Bulletin of the American Academy of Psychiatry and the Law, VII, 11–17, 1979
Lamb HR: The state hospital: facility of last resort.Am J Psychiatry 134:1151–1152, 1977
Zitrin A, Hardesty AS, Burdock EJ,et al.: Crime and violence among mental patients.Am J Psychiatry 133:142–149, 1976
Caton CLM: The new chronic patient and the system of community care.Hosp Community Psychiatry 32:475–478, 1981
Nuttall EA, Evenson RC, Cho DW,et al.: Patients of a public state mental health system who commit suicide.J Nerv Ment Dis 108:424–427, 1980
Haugland G, Craig TJ, Goodman AB, et al.: Mortality in the era of deinstitutionalization.Am J Psychiatry 140:848–852, 1983
Wing JK:The management of schizophrenia in the community, in Psychiatric Medicine. Edited by Usdin G. New York, Brunner Mazel Publishers, 1977
Wing JK: The social context of schizophrenia.Am J Psychiatry 135:1333–1338, 1978
Crowley TJ, Chesluk DC, Dilts S,et al.: Drug and alcohol abuse among psychiatric admissions—a multi drug clinical toxicologic study.Arch Gen Psychiatry 30:13–20, 1974
Hall RCW, Stickney SK, Gardner ER,et al.: Relationship of psychiatric illness to drug abuse.Journal of Psychedelic Drugs 11:337–342, 1979
McMahon D:The service delivery system and multi-disabled persons in New York State. Report to the Task Force on Multi-Disabilities, 1981
Cohen M, Klein DF: Posthospital adjustment of psychiatrically hospitalized drug users.Arch Gen Psychiatry 31:221–227, 1974
Treffert DA: Marijuana use in schizophrenia: a clear hazard.Am J Psychiatry 135:1213–1215, 1978
Strauss JS, Carpenter WT: The prediction of outcome in schizophrenia. I. Characteristics of outcome.Arch Gen Psychiatry 27:739–746, 1972
Hogarty GE, Goldberg SC: Drug and sociotherapy in the aftercare of schizophrenic patients.Arch Gen Psychiatry 28:54–64, 1973
Author information
Authors and Affiliations
Additional information
The authors wish to acknowledge the assistance of Marc H. Branchey, M.D. and Janet Avery in data collection and compilation; Joseph Wanderling, M.A. in programming and data management; Peg Fields in programming, Shang Lin, Ph.D. in programming, data management and statistical analysis; Elizabeth Vickers in data coding, Frances Simpson in manuscript preparation, Raymond Pass, Ph.D. in manuscript review, as well as the support of Charlotte E. Oliver, R.N., Director, Rockland Psychiatric Center.
Rights and permissions
About this article
Cite this article
Richardson, M.A., Craig, T.J. & Haugland, G. Treatment patterns of young chronic schizophrenic patients in the era of deinstitutionalization. Psych Quart 57, 104–110 (1985). https://doi.org/10.1007/BF01064328
Issue Date:
DOI: https://doi.org/10.1007/BF01064328