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Related Experiment Videos

Psychiatric emergency services: evolution, adaptation and proliferation.

E Wellin, D P Slesinger, C D Hollister

    Social Science & Medicine (1982)
    |January 1, 1987
    PubMed
    Summary

    Psychiatric emergency services (PES) have dramatically increased in number and utilization, adapting to diverse settings. These services, initially for acute care, now increasingly manage chronic mental health needs due to deinstitutionalization.

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    Area of Science:

    • Psychiatry and Mental Health Services Research
    • Health Services Administration
    • Public Health Policy

    Background:

    • Psychiatric emergency services (PES) evolved from disparate origins: general hospital emergency rooms, psychiatric hospital after-care, and the community mental health movement.
    • Community mental health legislation in the 1960s unified these services and provided crucial funding for their expansion.
    • The adaptability of PES is attributed to flexible staffing and minimal technological requirements, enabling integration into various healthcare settings.

    Observation:

    • PES have expanded significantly, from under 160 facilities in 1963 to over 2000 by the early 1980s.
    • Utilization rates for PES show a consistent upward trend, influenced by factors such as deinstitutionalization.
    • There is a notable shift in PES function, moving from primarily acute care to increasingly managing chronic mental health conditions.

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    Findings:

    • The number and variety of settings offering PES have grown substantially, including general hospitals, mental hospitals, free clinics, and hotlines.
    • Deinstitutionalization has led to PES becoming a de facto long-term care resource for many chronically ill individuals.
    • Demographic profiles of PES users and their utilization patterns are evolving, reflecting broader societal and healthcare system changes.

    Implications:

    • The increasing chronicization of PES highlights a gap in long-term care infrastructure for individuals with severe mental illness.
    • Understanding the evolving user demographics and service utilization is critical for optimizing mental healthcare delivery.
    • Further research is needed to address the challenges and opportunities presented by the expanding role and utilization of psychiatric emergency services.