This book is a research mono graph reporting empirical results, but we have tried to place the data in a very broad national perspective. Our intent is a volume on mental health policy in the United States, most notably our de facto policies, as indicated by empirical data. The book gives a broad perspective of mental disorders and mental disorder treatment in general hospitals in the United States. The audi ence that we ho pe to reach is those interested in mental health policy, planning, and treatment alternatives. The issues raised in this book are germane to anyone who is concerned with the problems that beset those see king treatment for mental or substance abuse disorders. We address the foUowing types of issues: (1) the history of health policy in the United States; (2) the history of our mental health policy as a eomponent of our health poliey; (3) the effeets of ehanges in payment policies; (4) mental disorders among special populations (children, the elderly, the disabled); (5) the cost of treatment; (6) changes in labeling of diagnosis; (7) the effectiveness of treatment; and (8) evolving public policy issues.

Contenu

Introduction. Hospitalization for Mental and Other Disorders. Public Policy Issues Affecting Psychiatric Inpatient Treatment. The National Context. Methods. The Baseline and Overall Data from 1980. Predicting Hospital LengthofStay for Psychiatric Inpatients. Who is Treated in Psychiatric Scatter Beds in General Hospitals? Changes in Site and Development of QuasiUnits. Who Pays? and to Whom? Case Mix and Dual Diagnoses. The Psychiatric Inpatient Treatment of Children and Youth in General Hospitals. Psychiatric Inpatient Treatment of the Elderly. Psychiatric Inpatient Treatment of the Disabled. Effects of Hospital Exemption from the Prospective Payment System. Summary of Empirical Findings. Some Scientific and Research Issues. Some Public Policy Issues. Conclusions. Index.