The effect of deinstitutionalization on a general hospital's inpatient psychiatric service

As a result of the deinstitutionalization movement, increasing numbers of former state hospital patients are being rehospitalized in general hospital psychiatric units. Because of this change in patient population, the general hospital has had to adjust its treatment strategy to emphasize meticulous review of previous psychiatric history, including medications; plans for meeting the patients' posthospital housing, vocational, and social needs; and development of plans with community care-givers for continuing care. General hospital staff members have to be educated to develop competence in working with the new patient population and a tolerance for chronicity; that can be done through several forums ranging from large staff meetings to individual supervision.