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Social class and psychiatric inpatient care: a twenty-five year perspective

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Summary

The authors present the major inpatient findings of the final survey conducted by the Trends in Mental Health project. This project, initiated by F.C. Redlich in 1975, is a limited follow-up of Hollingshead and Redlich's,Social class and mental illness. In spite of an enormous proliferation in psychiatric services in the survey's study region over the past 25 years, social class remains a major predictor of locus of inpatient care. In general, class II–IV patients have made significant shifts toward receiving private inpatient care. However, certain subgroups of lower-class patients — blacks, women and those with serious psychiatric disorders — still have limited access to private inpatient treatment. In addition, class V patients continued to exclusively utilize the public system. Deinstitutionalization and the shift of class IV and higher patients to private facilities have created a pooling of the most socially disabled patients on the public inpatient units. For example, almost 80% of all public inpatients were chronically unemployed and 60% lived alone when not hospitalized. The public policy implications of limited social access and the increased relative percentage of socially debilitated patients on public inpatient facilities are addressed.

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This work was partially funded by the Division of Biometry and Epidemiology, National Institute of Mental Health, Grant # MH35405 and the Mental Health Working Group, Center for Health Policy and Management, John F. Kennedy School of Government

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Mollica, R.F., Milic, M. Social class and psychiatric inpatient care: a twenty-five year perspective. Soc Psychiatry 21, 106–112 (1986). https://doi.org/10.1007/BF00582679

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Keywords

  • Social Class
  • Inpatient Care
  • Psychiatric Inpatient
  • Inpatient Unit
  • Private Facility