Overnight hospitalization of acutely ill day hospital patients

As the trend toward community-based treatment of the seriously mentally ill has continued, partial hospital programs have admitted an increasing number of highly symptomatic individuals. As a result, patient crises occur more often in these programs, and staff have had to develop novel crisis intervention strategies that do not rely on standard hospital care. One such strategy involves the use of "overnight hospitalization" or a "backup bed" to provide temporary safety and clinical management with the goal of returning the patient to the partial hospital within 24 hr. Given the lack of data on this intervention the present study was designed to provide further information about the implementation and effectiveness of this clinical strategy. The authors outline the rationale and procedures for a backup bed system and provide data on outcome that is drawn from an examination of backup bed utilization in a public-sector mental-health setting over a 1-year period. Clinical implications of the findings for future use of overnight hospitalization with partial hospital patients are reviewed.