Monthly Archives: April 2011

You are browsing the site archives by month.

Hospital Versus Outpatient Care in Mental Health

Deinstitutionalization has been a major theme of social administration for more than 20 years. In mental health, efforts were made to reform the public mental hospital through an expansion of community-based outpatient care. It was assumed that an increased use of outpatient care would reduce the use of the mental hospital. This study tested that assumption.

The state of Ohio served as the setting for the cross sectional design. The county was the unit of analysis. The influence of other community-based services and key social and economic variables was controlled. The data collected for all variables were for fiscal year 1978. Simple, partial, and multiple correlational analyses were used to test the main hypothesis and to control for the influence of the other study variables.

A null relationship was found between hospital care and outpatient care, even when the influence of other variables was controlled. A secondary search revealed highly significant relationships between hospital use and the alternative community-based services, inpatient care and day treatment. Significant relationships were also found between hospital care and the unemployment rate and the taxable base of the county. The most plausible explanation for the null finding between hospital care and outpatient care is that the two programs serve two or more distinct patient populations.

The positive relationships found between hospital care and the alternative mental health services provide empirical evidence for the well-known “revolving door” phenomenon. Further research is needed to determine the nature of the multiple patient populations, the nature of the population caught in the revolving door, and the nature of the significant relationships found between hospital care and the two social factors.