Assessing the acute inpatient psychiatric needs of the state hospital patient

Regulators have a major opportunity to enhance the community care of former state hospital patients through their power to authorize additional general hospital psychiatric beds. The authors propose a series of clinical criteria for such regulators based on a review of state hospital admissions. These include provisions for patients who have chronic illness with repeated hospitalizations, who are involuntarily admitted, who have alcoholism, and who are impoverished. Further implications for general hospital units include specific changes in their treatment strategy, their links to facilities for ambulatory patients, and their provisions for staff education and support.