APRIL++13+CAUSES+OF+DI+FINAL

APRIL++13+CAUSES+OF+DI+FINAL - US PUBLIC INPATIENT 18301955...

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US PUBLIC INPATIENT 1830- 1955 0 100 200 300 400 500 600 1830 1875 1920 1955 residents
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PUBLIC INPATIENT 1955-2006 0 100 200 300 400 500 600 1955 1970 1990 2006 residents
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RESIDENTS OF PUBLIC MENTAL HOSPITALS Drastic decline in residents,1955-2006 (“opening back door”) 1955 - 560,000; 1970 - 450,000; 1980 - 140,000; 1990 - 100,000; 2006 - 80,000 Increase in admissions 1955-1970, decrease since then (“closing the front door”)
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PUBLIC MENTAL HOSPITALS NOW No longer core of system Place of last resort - violent, difficult to treat (Frumkins) or nowhere else to go Still 2/3 of state expense on mental health Fixed costs, unions, communities
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CHANGE IN PATIENTS From elderly, long-term, schiz and brain disease To young, short-term, drug users (MICA) Same: poor, minorities, males
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INPATIENT TREATMENT NOW Most in general hospitals Growth of private , specialized hospitals Short stays – 1 to 2 weeks or until insurance runs out White, female, depression, alcohol, eating disorders Elderly now in nursing homes
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CAUSES OF DI 1. Drugs 2. Philosophical changes 3. Economic changes 4. Legal changes
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I. DRUG TREATMENT
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APRIL++13+CAUSES+OF+DI+FINAL - US PUBLIC INPATIENT 18301955...

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