Group therapy reduces medical and psychiatric hospitalization.

This article studies the impact of outpatient group therapy on medical care at a large city-county hospital. Of the 65 group therapy outpatients, 33 persons met the criterion of having attended at least 12 group sessions over the course of a year. We compared a control period (the year prior to initiating group therapy) with a study period (months 6-18 after starting group) and found a sharp decrease in the number of hospitalizations and in-hospital days. There was significantly increased use of neuroleptics and nonpsychotropics and increased attendance at nonpsychiatric clinics.     

Patient inquiry into mental hospitalization: a quantitative analysis.

In this section we have assembled a small collection of data concerned with the issue of whether or not adolescents would profit from reflective inquiry into the closed area of mental health care. We have analyzed, arranged and interpreted the data from our study and conclude it demonstrates that adolescent inpatients did profit substantially from a reflective inquiry into mental health care. The number of subjects involved in this experimental program was small. The subjects of the experimental program were not selected randomly. Moreover, the researcher could not control for a number of intervening variables. For this particular group the intervening variables were many: changes in the subjects' individual treatment program, level of tranquilizing medication, attitude of other staff toward the experimental program, relations with parents or relatives, et cetera. This list covers some of the more important weaknesses of the experimental design. In the account of the experiment we reported the influence of other significant intervening variables as they emerged during the course of the study. Even with these important limitations the total push of the results in the direction of our argument compels us to conclude that it is clearly profitable for adolescent inpatients to reflectively inquire into the closed area of mental health care. Although the data reported here are not of predictive value, we believe they indicate the importance of having adolescent inpatients reflectively examine their social situation.     

Psychiatric hospitalization after deliberate self-poisoning

The decision for psychiatric hospitalization after deliberate self-poisoning (DSP) is not well understood. This study, a longitudinal cohort study of 3,148 consecutive DSP patients found 920 (29.2%) subjects were referred for psychiatric hospitalization, 576 (18.3%) on involuntary basis. A logistic regression analysis showed increased risk for: age 25 or older, homelessness, unemployment, previous self-harm, psychiatric inpatient treatment within 12 months, earlier psychiatric inpatient treatment, suicidal ideation or plan, mood or psychotic disorders, and lower clinician experience; and lower risk for being married/defacto, and after hours presentation. Recommendation for psychiatric hospitalization was based on complex decision making. These findings have implications for clinical practice guidelines, service costs, and service organization.     

Duration of hospitalization and post discharge suicide

A retrospective cohort of discharged patients from all public psychiatric hospitals in Hong Kong (1997-1999) was linked to suicide data from Coroner's court. Patients hospitalized shorter than 15 days had significantly lower suicide rates than longer stay patients. The results were fairly consistent across immediate/late post discharge periods, gender, age, diagnoses, and narrow/wide definitions of suicide. This finding was opposite of what has been reported in the literature. Short hospitalization carried different suicide risks in different service settings.     

Spiritual opportunities in the liminal rites of hospitalization

This paper describes the way in which a hospital stay functions as a period of liminality. The opportunities for transformation inherent in such an experience are examined, with special attention given to the role of the hospital chaplain as the ritual leader who can help facilitate the movement through liminality and into wholeness.Ann Hallstein the M. Div. from Union Theological Seminary in May 1992 and expects to be ordained in the United Church of Christ.     

A perspective on the brief hospitalization of whole families

This paper reviews our experiences as an interdisciplinary team treating entire families who live in our hospital apartments. Over 100 families have now been treated. The therapeutic effort is based on the expectation that families have the capacity to employ staff support and skills, to solve problems and move competently through transitions of increasing complexity. We have found that it is essential to capitalize on the crisis that hospitalization entails in order to help families take more effective charge of their own lives.