Comparison of rehospitalized and nonrehospitalized psychiatric patients on community adjustment: self-assessment...

The measurement of community adjustment has become an essential component of community mental health program evaluation. The primary objective of community-oriented hospital psychiatric services is to return the patient to the community as quickly as possible, and to enable the patient to maintain himself in the community in a normal manner (Joint Commission on Mental Illness and Health, 1961). Attempts to evaluate hospital mental health programs have necessarily looked at measures of recidivism such as return rate and length of community tenure (Anthony et al., 1972; Rosenblatt and Mayer, 1974). For more immediate measures and qualitative assessment of community tenure, however, evaluators have relied on questionnaires that purport to measure community adaptation and social adjustment. A major reason for the use of community adjustment measures for evaluation in community-oriented hospital programs is the relative lack of predictive ability of any measures of patient adjustment while the patient is still in hospital (Ellsworth et al., 1968; Williams and Walker, 1961). It appears that all measures of success while the patient is still hospitalized, even goal-attainment measures, have little relationship to posthospital adjustment or recidivism (Willer and Miller, 1975). The present study examines the relationship of community adjustment to rehospitalization through comparison of rehospitalized and nonrehospitalized patients on a community adjustment scale.