Treatment of Severe Psychiatric Illness in a Day Hospital

Severity of psychiatric illness was assessed using standardised clinical and social measures in 69 in-patients and 41 day patients admitted consecutively from the community. Day and in-patients differed little in terms of psychiatric symptoms and social disability, especially if compulsory admissions were excluded. Protection of self or others was a common reason for in-patient admission given by clinicians, who were otherwise prepared to treat seriously ill patients in the day hospital. Very few of the day patients had to be transferred to the in-patient facility, and at three months and one year the two groups showed similar improvements. It is concluded that day treatment is feasible for some seriously ill psychiatric patients, but a random-allocation study is required to assess more completely the efficacy of day treatment, and define the characteristics of those who require in-patient admission.

[1]  F. Creed,et al.  Day-Hospital and Community Treatment for Acute Psychiatric Illness , 1989, British Journal of Psychiatry.

[2]  D. Tantam,et al.  Long-stay Patients in a Psychiatric Day Hospital , 1987, British Journal of Psychiatry.

[3]  J. Hoult.  Community Care of the Acutely Mentally Ill , 1986, British Journal of Psychiatry.

[4]  D. Cohen,et al.  Day and Full Time Psychiatric Treatment: A Controlled Comparison , 1985, British Journal of Psychiatry.

[5]  G. Wilkinson.  Day care for patients with psychiatric disorders. , 1984, British medical journal.

[6]  P. Vaughan.  The disordered development of day care in psychiatry. , 1983, Health trends.

[7]  R. Shelley,et al.  Day Patient versus In-patient: Factors Determining Selection of Acutely Ill Patients for Hospital Treatment , 1983, British Journal of Psychiatry.

[8]  I. G. Pryce.  An Expanding ‘Stage Army’ of Long-Stay Psychiatric Day-Patients , 1982, British Journal of Psychiatry.

[9]  G. Szmukler,et al.  Compulsory admissions in a London borough: I. Social and clinical features and a follow-up , 1981, Psychological Medicine.

[10]  S. Hirsch,et al.  Caution and conservatism in the use of a psychiatric day hospital: Evidence from a research project that failed , 1980, Psychiatry Research.

[11]  S. Hirsch,et al.  Clinical Change as a Function of Brief Admission to Hospital in a Controlled Study Using the Present State Examination , 1980, British Journal of Psychiatry.

[12]  L. Stein,et al.  Alternative to mental hospital treatment. I. Conceptual model, treatment program, and clinical evaluation. , 1980, Archives of general psychiatry.

[13]  E. Struening,et al.  A comparative trial of home and hospital psychiatric care. One-year follow-up. , 1979, Archives of general psychiatry.

[14]  P. Tyrer,et al.  CONTROLLED COMPARISON OF DAY-HOSPITAL AND OUTPATIENT TREATMENT FOR NEUROTIC DISORDERS , 1979, The Lancet.

[15]  S. Hirsch,et al.  Shortening hospital stay for psychiatric care: effect on patients and their families , 1979, British medical journal.

[16]  M. Vannicelli,et al.  A controlled comparison of psychiatric day treatment and inpatient hospitalization. , 1976, Journal of consulting and clinical psychology.

[17]  B. Gordo,et al.  Community care for the mentally ill. , 1976, Nursing times.

[18]  M. H. Michaux,et al.  Postrelease adjustment of day and full-time psychiatric patients. , 1973, Archives of general psychiatry.

[19]  J. Endicott,et al.  Day versus inpatient hospitalization: a controlled study. , 1971, The American journal of psychiatry.

[20]  J. Wilder,et al.  A two-year follow-up evaluation of acute psychotic patients treated in a day hospital. , 1966, The American journal of psychiatry.

[21]  G. Hogarty,et al.  "Who goes there?"--A critical evaluation of admissions to a psychiatric day hospital. , 1968, The American journal of psychiatry.