The mental healthcare crisis in America demands our immediate attention. We're witnessing a disturbing pattern where individuals with documented histories of serious mental illness cycle through brief institutional stays, only to be released back into society without adequate support systems—often with devastating consequences.

Common reasons for institutionalization (multiple sources):

– Severe depression

– Suicidal behavior, thoughts, or threats

– Schizophrenia

– Hallucinations or delusions

– Lack of sleep or food intake for several days

– Severe substance abuse issues

– Inability to meet basic needs like eating or bathing

– Ineffective response to previous medications and therapies

Source 1:

https://pmc.ncbi.nlm.nih.gov/articles/PMC10338701/pdf/10.1177_00207640221143282.pdf

In summary, this article explores the recent change (over last several decades) in treatment pf psychiatric patients from long term hospitalization to short-terms stays and/or outpatient services.

Noteworthy points/findings:

-"Revolving door" (RD) treatments tend to impact a patient group that is younger, single, unemployed, of low education level (less than a high school degree), and with diagnosis of a psychotic disorder. Many of these characteristics would mark a patient "at risk" and yet they're receiving inadequate revolving door treatment.

-This shift to revolving door treatment is partially attributed to improvement in community-based/outpatient services.

-Definition of revolving door patients: those patients requiring a large amount of mental health derived resources (20-30%), thought they represent less than 10% of the total number of patients (small populations requiring a sizable amount of service)

-The research efforts to specifically identify the factors leading to multiple hospitalizations has been controversial, but these authors offer a systematic review to analyze existing research on the topic and forecast the types of patients who will likely receive RD treatments and risk ongoing rehospitalization.

-The studies reviewed in this article have some different and conflicting findings, but there were some common observations:

*RD phenomenon is greater in younger age groups (esp among those between 15-45 years old)

*No particular gender is associated with RD phenomenon.

*No particular ethnicity is associated with RD phenpmeon.

*RD treatments seems to occur more frequently in urban areas, as opposed to suburban or rural areas.

*RD seems to occur more in single or unmarried patients as opposed to married patients.

*It has been commonly noted that family plays a significant role in RD treatments; patients with family conflict often fall into the RD population, where patients with supportive family are more likely to require non-heavy use of psychiatric services.

*RD seems to be heavily associated with patients who are unemployed or receiving disability pension.

*RD patients were significantly likely to have been diagnosed with schizophrenia, personality disorder, or alcohol/substance abuse

Source 2:

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What part of the game is that. August 2022
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