PSYCHOLOGICAL SERVICES FOR CHRONIC MENTAL PATIENTS IN STATE AND VA HOSPITALS

A questionnaire was submitted to all state and VA hospitals caring for chronically mentally ill patients. Responses were received from 67% and 77% respectively. The survey indicates that VA hospitals are making much greater use of psychological services with chronic patients. Approximately one-fourth of state hospitals do not provide any such service. While the VA hospitals utilize psychological services to a greater extent, both state and VA hospitals make limited use of full-time psychologists. Where part-time personnel is utilized, they spend, for the most part, less than 50% of their time with chronic patients. A considerable portion of the psychological services for chronic patients is performed by trainees rather than by fully trained staff at the Ph. D. level. The survey indicates that one of the great needs is for psychotherapy and that psychologists in the VA hospitals are being used more extensively in providing both individual and group psychotherapy for chronic patients. The survey uncovered in both state and VA hospitals a substantial discrepancy between the current ratio of psychologists to patients, and that recommended by both the Veterans Administration and The American Psychiatric Association. While the Veterans Administration recommends one psychologist for every 300 chronic patients and The American Psychiatric Association one for every 500, the survey indicates that veterans hospitals have one full-time psychologist for every 720 patients and state hospitals one for every 4,907. The paper describes the various psychological services being performed by psychologists working with chronic patients.