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Equity and changing patient characteristics--1950 to 1975

R F Mollica, F Redlich

    Archives of General Psychiatry
    |November 1, 1980
    PubMed
    Summary
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    Comparing psychiatric patient treatment in 1950 and 1975 reveals that even with more services, low-income patients still receive state hospital care and low-intervention treatments, raising equity concerns.

    Area of Science:

    • Social Science
    • Psychiatry
    • Health Services Research

    Background:

    • This study revisits Hollingshead and Redlich's seminal work on social class and mental illness.
    • It examines changes in psychiatric treatment patterns over 25 years in a northeastern industrial community.

    Purpose of the Study:

    • To compare psychiatric treatment patterns in 1950 and 1975.
    • To assess the treatment settings for patients historically excluded or solely reliant on state hospitals.
    • To explore equity issues in mental healthcare access and delivery.

    Main Methods:

    • A follow-up survey comparing treatment data from 1950 and 1975.
    • Analysis focused on patient groups with limited access to care in 1950.
    • Examination of inpatient and outpatient treatment settings and staffing.

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    Main Results:

    • Despite increased psychiatric services, state hospitals remain a primary inpatient setting for historically underserved patient groups.
    • These patients are increasingly found in public units with low-intensity treatments and non-professional staff.
    • Significant disparities in care settings and treatment intensity persist.

    Conclusions:

    • Proliferation of mental health services has not eliminated inequities for low-status patients.
    • Findings highlight ongoing social class disparities in psychiatric care.
    • The study prompts critical social policy questions regarding mental healthcare equity.