Nonsegregated Acute Psychiatric Admissions to General Hospitals — Continuity of Care within the Community Hospital

Abstract

Over a four-year period, 344 patients were admitted as acute psychiatric emergencies to nonpsychiatric units of the three general hospitals of a rural county. After appointment of the psychiatrist as an active member of a medical staff, and with the help of indoctrination exercises, this admission procedure was well accepted by administration, by the physician and nursing staff, and by the patients with private conventional medical disorders who were roommates of those with psychiatric complaints. The median duration of hospitalization was 6.5 to 8.5 days as compared to 30 days in the Regional State Hospital and 24 days in psychiatric units of general hospitals. The proportion of general readmissions was 18 per cent. The nonpsychiatric unit of the general hospital is proposed as a satisfactory alternative, for the care of the acute phase of mental illness, to the traditional forms of psychiatric hospitalization. (N Engl J Med 289:185–189, 1973)