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The effect of a mental hospital strike on general hospital psychiatric services

Published online by Cambridge University Press:  09 July 2009

Ross M. G. Norman  and
Ashok K. Malla
Ross M. G. Norman*
Affiliation:
Waterford Hospital, St John's, Newfoundland, Canada
Ashok K. Malla
Affiliation:
Waterford Hospital, St John's, Newfoundland, Canada
*
1Address for correspondence: Dr Ross M. G. Norman, Division of Community Medicine, Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland, Canada A1B 3V6.
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Synopsis

Data collected from 6043 psychiatric in-patient records were analysed to assess the impact of a strike at a mental hospital on in-patient services in general hospital psychiatric units in St John's, Newfoundland, Canada. As a whole, during the strike general hospital units showed an increase in the number of involuntary admissions, the number of prior mental hospital admissions of patients, and indications of violent or suicidal behaviour; and a decrease in the occupational status of patients admitted and the prescription of minor tranquillizers. There was also evidence of considerable variation between general hospitals in the extent to which their admission pattern changed during the strike and the permanence of some of the strike effects. The data indicate that all patients showing violent or suicidal behaviour who would normally have been admitted to the mental hospital were treated in the general hospital units during the strike. On the other hand, a large number of patients diagnosed with schizophrenia, personality disorder or mental retardation, who normally would have been admitted to the mental hospital, apparently went without hospitalization during the strike. A substantial proportion of this latter group would usually have been admitted involuntarily.

Type
Research Article
Information
Psychological Medicine , Volume 14 , Issue 4 , November 1984 , pp. 913 - 921
Copyright
Copyright © Cambridge University Press 1984

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References

Ahmed, P. I. & Plog, S. E. (eds.) (1976). State Mental Hospitals: What Happens When They Close. Plenum: New York.CrossRefGoogle Scholar
Baker, A. A. (1969). Psychiatric unit in a district general hospital. Lancet i, 1090–1092.CrossRefGoogle Scholar
Bassuk, E. L. (1980). The impact of deinstitutionalization on the general hospital psychiatric unit. Hospital and Community Psychiatry 31, 623–627.Google Scholar
Bower, C. P., Padia, W. L. & Glass, G. V. (1974). T.M.S.: Two Fortran IV Programs for Analysis of Time-Series Experiments. Laboratory of Educational Research: University of Colorado.Google Scholar
Cotton, P. G., Bene-Kociemba, A. & Cole, R. (1979). The effect of deinstitutionalization on a general hospital's inpatient psychiatric service. Hospital and Community Psychiatry 30, 609–612.Google ScholarPubMed
Crammer, J. L. (1969). Psychiatric unit in a general hospital (Letter). Lancet i, 1216–1217.CrossRefGoogle Scholar
Department of Health and Social Security(1971). Hospital Services for the Mentally III. HMSO: London.Google Scholar
Fakhruddin, A. K. M., Manjooran, A., Nair, N. P. V. & Neufeldt, A. (1972). A five-year outcome of discharged chronic psychiatric patients. Canadian Psychiatric Association Journal 17, 433–435.CrossRefGoogle ScholarPubMed
Freeman, H. L. (1960). Oldham and district psychiatric service. Lancet i, 218–221.CrossRefGoogle Scholar
Goldberg, D. P. & Jones, R. (1980). The costs and benefits of psychiatric care. In The Social Consequences of Psychiatric Illness (ed. Robins, L.Clayton, P. and Wing, J. K.), pp. 55–70. Brunner/ Mazel: New York.Google Scholar
Greenblatt, M. & Glazier, E. (1975). The phasing out of mental hospitals in the United States. American Journal of Psychiatry 132, 1135–1140.Google ScholarPubMed
Greenhill, M. H. (1979). Psychiatric units in general hospitals: 1979. Hospital and Community Psychiatry 30, 169–182.Google ScholarPubMed
Herjanic, M., Stewart, A. & Hales, R. D. (1968). The chronic patient in the community: a two year followup of 338 chronic patients. Canadian Psychiatric Association Journal 13, 231–235.CrossRefGoogle Scholar
Heseltine, G. F. (1982). Blueprint for Change: The Next Ten Years. Interim Report. Ontario Ministry of Health: Toronto.Google Scholar
Jones, R., Goldberg, D. P. & Hughes, B. (1980). A comparison of two different services treating schizophrenia: a cost-benefit approach. Psychological Medicine 10, 493–507.CrossRefGoogle ScholarPubMed
Kanno, C. & Scheidemandel, P. L. (1974). Psychiatric Treatment in the Community: A National Survey of General Hospital Psychiatry and Private Psychiatric Hospitals. Joint Information Service: Washington D.C.Google Scholar
Kiesler, C. A. (1982). Mental hospitals and alternative care: noninstitutionalization as potential public policy for mental patients. American Psychologist 37, 349–360.CrossRefGoogle ScholarPubMed
Leeman, C. P. (1980). Involuntary admissions to general hospitals: progress or threat? Hospital and Community Psychiatry 31, 315–318.Google ScholarPubMed
Leeman, C. P. & Berger, H. S. (1980). The Massachusetts Psychiatric Society's position paper on involuntary psychiatric admissions to general hospitals. Hospital and Community Psychiatry 31, 318–324.Google ScholarPubMed
Little, J. C. (1963). Development of a psychiatric unit in a large general hospital. Lancet i, 376–377.CrossRefGoogle Scholar
Mahadevan, S. & Forster, D. P. (1982). Psychiatric units in district general hospitals and traditional mental hospitals: some recent evidence. British Journal of Psychiatry 140, 160–165.CrossRefGoogle ScholarPubMed
Malla, A. K. & Norman, R. M. G. (1983). Mental hospital and general hospital psychiatric units: a comparison of services within the same geographic area. Psychological Medicine 13, 431–439.CrossRefGoogle ScholarPubMed
Mann, H. B. & Whitney, D. R. (1947). On a test of whether one of two random variables is stochastically larger than the other. Annals of Mathematical Statistics 18, 50–60.CrossRefGoogle Scholar
National Institute of Mental Health (1977). Occupancy Trends, Psychiatric Inpatient Services, 1971–1975. Division of Biometry and Epidemiology: Rockville, MD.Google Scholar
Orwin, A. & Sims, M. (1965). The mental hospital - effects of an alternative psychiatric service. Lancet i, 644–647.CrossRefGoogle Scholar
Smith, C. M. & McKerracher, D. G. (1964). The comprehensive psychiatric unit in the general hospital. American Journal of Psychiatry 121, 52–57.CrossRefGoogle ScholarPubMed
Tidmarsh, D. (1969). Psychiatric unit in a general hospital (Letter). Lancet i, 1264.CrossRefGoogle Scholar
Vischi, T. R., Jones, K. R., Shank, E. L. & Lima, L. H. (1980). The Alcohol, Drug Abuse, and Mental Health Data Book. US Department of Health, Education and Welfare: Washington, D.C.Google Scholar
World Health Organization (1971). Trends in Psychiatric Care: Day Hospitals and Units in General Hospitals: Report on a Symposium. Salzburg, June 1971. WHO: Copenhagen.Google Scholar