Am J Psychiatry 1992; 149:385-390
Copyright © 1992 by American Psychiatric Association
The relationship between community resources and state hospital recidivism
WH Fisher, JL Geller, F Altaffer and MB Bennett
Department of Psychiatry, University of Massachusetts Medical School, Worcester 01655.
OBJECTIVE: The authors examined the propositions that a revolving state
hospital door is an inevitable consequence of deinstitutionalization and
that enhancing resources for community-based care can limit this
phenomenon. METHOD: They analyzed the recidivism patterns of state hospital
patients in a region of Massachusetts where, because of a federal court
consent decree, the level of funding for community programs was more than
twice as high as it was in other regions in the state and compared the
pattern of recidivism in this region with that observed in the other areas
of the state. RESULTS: Despite the fact that the average daily state
hospital census in the resource-rich region was only half that of the other
regions, longitudinal data on hospital use showed that the readmission
patterns were similar in all state regions. CONCLUSIONS: The authors
suggest that attributes of serious and persistent mental illness may have
more effect on hospital readmission patterns than service system variables.
