title: Long-stay patients in state psychiatric hospitals at the end of the 20th century.
abstract: OBJECTIVE
  The purpose of this study was to assess the characteristics of long-stay patients in contemporary state psychiatric hospitals and to identify factors representing possible barriers to alternative placements for these patients.
  
  
  METHODS
  All patients in inpatient units of the Massachusetts Department of Mental Health who had been hospitalized for at least three years as of April 1, 1999, were assessed by their treatment teams with a standardized data collection instrument. Domains assessed included medical problems, need for nursing care, psychiatric diagnosis, and history of problematic behaviors.
  
  
  RESULTS
  The 330 individuals identified as long-stay patients had an array of medical problems and nursing care needs that likely would have been manageable in other long-term-care settings. A total of 276 patients had at least one significant medical problem. However, some patients exhibited behavioral problems that might have complicated such placements, especially when behavioral problems co-occurred with the need for medical supervision. A total of 228 patients had exhibited a significant problematic behavior in the previous 30 days.
  
  
  CONCLUSIONS
  Although the number of long-stay patients in state psychiatric hospitals declined dramatically during the second half of the 20th century, a small group of patients still requires care in this setting. State psychiatric hospitals continue to occupy a significant niche in the mental health system.
authors.affiliation: University of Massachusetts Medical School, Worcester 01655, USA. bill.fischer@umassmed.edu
authors.forename: W H
authors.initials: WH
authors.lastname: Fisher
authors.forename: P J
authors.initials: PJ
authors.lastname: Barreira
authors.forename: J L
authors.initials: JL
authors.lastname: Geller
authors.forename: A W
authors.initials: AW
authors.lastname: White
authors.forename: A K
authors.initials: AK
authors.lastname: Lincoln
authors.forename: M
authors.initials: M
authors.lastname: Sudders
mesh_terms: D005260:Female; D049673:History, 20th Century; D006760:Hospitalization / Q000706:statistics & numerical data*; D006778:Hospitals, Psychiatric / Q000266:history; D006783:Hospitals, State / Q000266:history; D006801:Humans; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D008605:Mental Health Services / Q000266:history / Q000706:statistics & numerical data* / Q000639:trends; D014481:United States