The impact of deinstitutionalization on the general hospital psychiatric emergency ward

To delineate the role of a general hospital emergency ward in the treatment of deinstitutionalized patients, the author analyzed the demographic and clinical characteristics of a systematic sample of 663 patients appearing for emergency ward treatment over a four-year period between 1972 and 1976. Yearly comparisons of the data were made to identify changing trends in the patient population. Variables studied generally remained constant from 1972 through 1975, but by 1976 several important changes were noted, among them an increase in the number of patients previously hospitalized in state facilities, a marked decrease in patients with no previous hospitalizations, and an increase in patients exhibiting psychotic behavior. The author considers the factors that may have contributed to the delay in the arrival of deinstitutionalized patients at the emergency ward. She also emphasizes the need for general hospitals to develop and implement comprehensive programs for the management of the increasing numbers of sicker patients appearing for treatment.