Hostname: page-component-6bf8c574d5-vmclg Total loading time: 0 Render date: 2025-02-21T16:23:54.967Z Has data issue: false hasContentIssue false
  • English
  • Français

Day-Hospital and Community Treatment for Acute Psychiatric Illness

A Critical Appraisal

Published online by Cambridge University Press:  02 January 2018

Francis Creed ,
Dawn Black  and
Philip Anthony
Francis Creed*
Affiliation:
Manchester Royal Infirmary
Dawn Black
Affiliation:
Manchester Royal Infirmary
Philip Anthony
Affiliation:
Manchester Royal Infirmary
*
∗Department of Psychiatry, Rawnsley Building, Manchester Royal Infirmary, Oxford Road, Manchester M13
Get access Rights & Permissions [Opens in a new window]

Abstract

Findings on the efficacy of day-hospital and community treatment for acutely ill psychiatric patients have been contradictory. This review confirms the methodological problems previously noted, but highlights the variation in feasibility of day care: staffing levels and the attitudes of staff appear to have been responsible, along with the severity and chronicity of illness. The comparison of day and in-patient care to see which is 'superior’ has been unrewarding, and further research is needed. Day-hospital treatment is unlikely to be more widely used for acutely ill patients until: (a) there is clear evidence that certain patients are best treated in this way; (b) the social and clinical characteristics of such patients are defined; (c) adequate staffing is achieved (i.e. day care is not regarded as a cheap option); and (d) day centres are available for chronic patients.

Type
Review Articles
Information
The British Journal of Psychiatry , Volume 154 , Issue 3 , March 1989 , pp. 300 - 310
Copyright
Copyright © Royal College of Psychiatrists, 1989 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Avison, W. R. & Speechley, K. N. (1987) The discharged psychiatric patient: a review of social-psychological and psychiatric correlates of outcome. American Journal of Psychiatry, 144, 1.Google Scholar
Bowman, E. P., Shelley, R. K., Sheehy-Skeffington, A., et al (1983) Day patient versus in-patient: factors determining selection of acutely ill patients for hospital treatment. British Journal of Psychiatry, 142, 584–587.CrossRefGoogle ScholarPubMed
Braun, P., Kochansky, G., Greenberg, S., et al (1981) Overview: deinstitutionalization of psychiatric patients, a critical review of outcome studies. American Journal of Psychiatry, 138, 736–749.Google ScholarPubMed
Carney, M. W. P., Ferguson, R. S. & Sheffield, B. F. (1970) Psychiatric day hospital and community. Lancet, i, 1218–1220.CrossRefGoogle Scholar
Cowen, E. L. (1978) Some problems in community program evaluation research. Journal of Consulting and Clinical Psychology, 46, 792–805.CrossRefGoogle ScholarPubMed
Creed, F. H., Anthony, P., Godbert, K., et al (1989) Treatment of severe psychiatric illness in a day hospital. British Journal of Psychiatry, 154, 341–347.CrossRefGoogle Scholar
Department of Health and Social Security (1969) A pilot survey of patients attending day hospitals. DHSS Statistical Reports No. 7. London: DHSS.Google Scholar
Department of Health and Social Security (1975) Better Services for the Mentally Ill. Cmnd 6233. London: HMSO.Google Scholar
Dick, P., Cameron, L., Cohen, D., et al (1985a) Day and full time psychiatric treatment: a controlled comparison. British Journal of Psychiatry, 147, 246–250.CrossRefGoogle ScholarPubMed
Dick, P., Ince, A. & Barlow, M. (1985b) Day treatment: suitability and referral procedure. British Journal of Psychiatry, 147, 250–253.CrossRefGoogle ScholarPubMed
Endicott, J., Cohen, J., Nee, J., et al (1979) Brief versus standard hospitalization. For whom? Archives of General Psychiatry, 36, 706–712.CrossRefGoogle Scholar
Fadden, G., Bebbington, P. & Kuipers, L. (1987) The burden of care: the impact of functional psychiatric illness on the patient's family. British Journal of Psychiatry, 150, 285–292.CrossRefGoogle ScholarPubMed
Fenton, F. R., Tessier, L. & Struening, E. L. (1979) A comparative trial of home and hospital psychiatric care. Archives of General Psychiatry, 36, 1073–1079.CrossRefGoogle ScholarPubMed
Fink, E. B., Longabaugh, R. & Stout, R. (1978) The paradoxical underutilization of partial hospitalization. American Journal of Psychiatry, 135, 713–716.Google ScholarPubMed
Gath, D., Hassal, C. & Cross, K. W. (1973) Whither psychotic day patients? A study of day patients in Birmingham. British Medical Journal, i, 94–98.CrossRefGoogle Scholar
Glick, I. D., Fleming, L., DeChillo, N., et al (1986) A controlled study of transitional day care for non-chronically-ill patients. American Journal of Psychiatry, 143, 1551–1556.Google ScholarPubMed
Greene, L. R. & de la Cruz, A. (1981) Psychiatric day treatment as alternative to and transition from full time hospitalization. Community Mental Health Journal, 17, 191–202.CrossRefGoogle ScholarPubMed
Gudeman, J. E., Shore, M. F. & Dickey, B. (1983) Day hospitalization and an inn instead of in-patient care for psychiatric patients. New England Journal of Medicine, 308, 749–753.CrossRefGoogle Scholar
Gudeman, J. E., Dickey, B., Evans, A., et al (1985) Four-year assessment of a day hospital–inn program as an alternative to in-patient hospitalization. American Journal of Psychiatry, 142, 1330–1333.Google Scholar
Guy, W. & Gross, G. W. (1967) Problems in the evaluation of day hospitals. Community Mental Health Journal, 3, 111–118.CrossRefGoogle ScholarPubMed
Herz, M. I., Endicott, J., Spitzer, R. L., et al (1971) Day versus in-patient hospitalization, a controlled study. American Journal of Psychiatry, 127, 1371–1381.CrossRefGoogle Scholar
Herz, M. I., Endicott, J. & Spitzer, R. L. (1975) Brief hospitalization of patients with families: initial results. American Journal of Psychiatry, 132, 413–417.Google ScholarPubMed
Hogarty, G. E., Dennis, H., Guy, W., et al (1968) “Who goes there?” – A critical evaluation of admissions to a psychiatric day hospital. American Journal of Psychiatry, 124, 934–1003.CrossRefGoogle ScholarPubMed
Hoult, J. (1986) Community care of the acutely mentally ill. British Journal of Psychiatry, 149, 137–144.CrossRefGoogle ScholarPubMed
Kennedy, P. & Hird, F. (1980) Description and evaluation of a short-stay admission ward. British Journal of Psychiatry, 136, 205–215.CrossRefGoogle ScholarPubMed
Kiesler, C. A. (1982) Mental hospitals and alternative care – noninstitutionalization as potential public policy for mental patients. American Psychologist, 37, 349–360.CrossRefGoogle ScholarPubMed
Knights, A., Hirsch, S. R. & Platt, S. D. (1980) Clinical change as a function of brief admission to hospital in a controlled study using the present state examination. British Journal of Psychiatry, 137, 170–180.CrossRefGoogle Scholar
Lancet (1985) Day hospitals for psychiatric care. Lancet, ii, 1106–1107.Google Scholar
Lancet (1987) Psychiatric day hospitals for all? Lancet, ii, 1184–1185.Google Scholar
Lavik, N. J. (1983) Utilization of mental health services over a given period. Acta Psychiatrica Scandinavica, 67, 404–413.CrossRefGoogle Scholar
Lipsius, S. H. (1973) Judgements of alternatives to hospitalization. American Journal of Psychiatry, 130, 892–896.CrossRefGoogle ScholarPubMed
McGrath, G. & Tantam, D. (1987) Long-stay patients in a psychiatric day hospital: a case note review. British Journal of Psychiatry, 150, 836–870.CrossRefGoogle Scholar
Michaux, M. H., Chelst, M. R., Foster, S. A., et al (1973) Postrelease adjustment of day and full-time psychiatric patients. Archives of General Psychiatry, 29, 647–651.CrossRefGoogle ScholarPubMed
Mosher, L. (1983) Alternatives to psychiatric hospitalization – why has research failed to be translated into practice. New England Journal of Medicine, 399, 1579–1580.CrossRefGoogle Scholar
Penk, W. E., Charles, H. L. & Van Hoose, T. A. (1978) Comparative effectiveness of day hospital and in-patient psychiatric treatment. Journal of Consulting and Clinical Psychology, 46, 94–101.CrossRefGoogle Scholar
Platt, S. (1985) Measuring the burden of psychiatric illness on the family: an evaluation of some rating scales. Psychological Medicine, 15, 383–393.CrossRefGoogle ScholarPubMed
Platt, S., Knights, A. C. & Hirsch, S. R. (1980) Caution and conservatism in the use of a psychiatric day hospital: evidence from a research project that failed. Psychiatric Research, 3, 123–132.CrossRefGoogle ScholarPubMed
Potomianos, G., North, W. R. S., Meade, T. W., et al (1986) Randomised trial of community-based centre versus conventional hospital management in treatment of alcoholism. Lancet, ii, 797–799.CrossRefGoogle Scholar
Rosie, J. S. (1987) Partial hospitalization: a review of recent literature. Hospital and Community Psychiatry, 38, 1291–1299.Google ScholarPubMed
Schene, A. H. & Gersons, B. P. R. (1986) Effectiveness and application of partial hospitalization. Acta Psychiatrica Scandinavica, 74, 335–340.CrossRefGoogle ScholarPubMed
Stein, L. I. & Test, M. A. (1980) Alternatives to mental hospital treatment. 1. Conceptual model, treatment programme and clinical evaluation. Archives of General Psychiatry, 37, 392–397.CrossRefGoogle Scholar
Szmukler, G. I., Bird, A. S. & Button, E. J. (1981) Compulsory admissions in a London borough. 1. Social and clinical features and a follow-up. Psychological Medicine, 11, 617–636.CrossRefGoogle Scholar
Tantam, D. (1985) Alternatives to psychiatric hospitalisation. British Journal of Psychiatry, 146, 1–4.CrossRefGoogle ScholarPubMed
Tyrer, P. J. & Remington, M. (1979) Controlled comparison of day-hospital and outpatient treatment for neurotic disorders. Lancet, i, 714–716.Google Scholar
Tyrer, P. J., Remington, M. & Alexander, J. (1987) The outcome of neurotic disorders after outpatient and day hospital care. British Journal of Psychiatry, 151, 57–62.CrossRefGoogle ScholarPubMed
Vaughan, P. J. (1983) The disordered development of day care in psychiatry. Health Trends, 15, 91–94.Google ScholarPubMed
Vaughan, P. J. (1985) Developments in psychiatric day care. British Journal of Psychiatry, 147, 1–4.CrossRefGoogle ScholarPubMed
Washburn, S. & Vannicelli, M. (1976) A controlled comparison of psychiatric day treatment and in-patient hospitalization. Journal of Consulting and Clinical Psychology, 44, 665–675.CrossRefGoogle Scholar
Washburn, S., Vannicelli, M. & Scheff, B. (1976) Irrational determinants of the place of psychiatric treatment. Hospital and Community Psychiatry, 27, 179–182.Google ScholarPubMed
Weisbrod, B. A., Test, M. A. & Stein, L. I. (1980) Alternative to mental hospital II: economic cost-benefit analysis. Archives of General Psychiatry, 37, 400–405.CrossRefGoogle Scholar
Wilder, J. F., Levin, G. & Zwerling, I. (1966) A two year follow up evaluation of acute psychotic patients treated in a day hospital. American Journal of Psychiatry, 122, 1095–1101.CrossRefGoogle Scholar
Wilkinson, G. (1984) Day care for patients with psychiatric disorders. British Medical Journal, 288, 1710–1711.CrossRefGoogle ScholarPubMed
Wing, L., Wing, J. K., Stevens, B., et al (1972) An epidemiological and experimental evaluation of industrial rehabilitation of chronic psychotic patients in the community. In Evaluating a Community Psychiatric Service (eds Wing, J. K. & Hailey, A. M.). Oxford: Oxford University Press.Google Scholar
Zwerling, I. & Wilder, J. F. (1964) An evaluation of the applicability of the day hospital in treatment of acutely disturbed patients. Israel Journal of Psychiatry and Related Disciplines, 2, 162–185.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.