Factors compelling psychiatric hospitalization in crisis

At a time in a large community mental health center when all adjunct facilities were geared for crises, the compelling determinants in those patients still requiring hospitalization were studied. It was found that all patients answered affirmatively to one or more of the following six categories as occurring in their prehospital life: 1) alcohol abuse; 2) other drug abuse; 3) suicidal attempt; 4) a recent loss; 5) stoppage (or reduction) of medication; 6) stoppage of outpatient treatment. It was found that those patients diagnosed schizophrenic (69 per cent) did not significantly differ in the number of affirmative answers given in each of the six categories when compared to the total patient population. The most frequent categories to which an affirmative answer was given were stoppage of medication and stoppage of outpatient treatment. There did appear to be a trend for various combinations of these categories in a give patients. The schizophrenic group tended to have more affirmative answers in combinations of categories 3 and 4. The importance of these findings in the hospitalization and follow-up treatment of psychiatric patients is discussed.