The Place of the Partial Hospital in the Treatment of Chronic Psychiatric Patients

Abstract

In the past several years the political ferment focused on the increasing presence of long-term mental hospital patients in the community has stirred thoughtful reactions by many professional as well as political groups. The report in 1977 of the President’s Commission on Mental Health, as well as the official position statement of the American Psychiatric Association in 1978, focused on the systems defects in the country’s attempts to make effective care available to chronic patients throughout the country. Ironically, these very issues had been previously addressed in the Community Mental Health Centers Act of 1963. This act mandated the structures needed for the care of chronic and acute psychiatric patients. Since that time, clusters of inpatient and outpatient units, as well as day, evening and night care programs, have been established in increasing numbers. Some, such as the Day-Night unit at the Allen Memorial Institute in Montreal or the Day Hospital at the Massachusetts Mental Health Center, had been functioning effectively years before the landmark federal legislation had been passed. Grouped under the name of partial hospitalization, these units developed a capacity for treating both acute and chronic patients. By 1968 there was one partial hospital patient for every 40 psychiatric inpatients in the U.S. This trend has continued. By 1976 the ratio had increased to one in 10 and day treatment units had increased to 1,458 in 3,495 mental health facilities of all types.