The effect of a mental hospital strike on general hospital psychiatric services

Data collected from 6043 psychiatric in-patient records were analysed to assess the impact of a strike at a mental hospital on in-patient services in general hospital psychiatric units in St John's, Newfoundland, Canada. As a whole, during the strike general hospital units showed an increase in the number of involuntary admissions, the number of prior mental hospital admissions of patients, and indications of violent or suicidal behaviour; and a decrease in the occupational status of patients admitted and the prescription of minor tranquillizers. There was also evidence of considerable variation between general hospitals in the extent to which their admission pattern changed during the strike and the permanence of some of the strike effects. The data indicate that all patients showing violent or suicidal behaviour who would normally have been admitted to the mental hospital were treated in the general hospital units during the strike. On the other hand, a large number of patients diagnosed with schizophrenia, personality disorder or mental retardation, who normally would have been admitted to the mental hospital, apparently went without hospitalization during the strike. A substantial proportion of this latter group would usually have been admitted involuntarily.