EXPLORATIONS IN ALTERNATIVES TO HOSPITALIZATION

During a 6-month period, the Community Extension Service sought alternatives to hospitalization for 37 persons awaiting admission to the Massachusetts Mental Health Center; 18 (49%) were successfully treated as outpatients, and remained in the community for at least 12 months, and 19 (51%) were hospitalized. It is concluded that alternatives to inpatient care can be provided for a significant number of persons who are referred for admission, and that the cost of these alternatives is no greater than the cost of ward care. Special personnel, unusual techniques, and elaborate resources are not required for these alternatives. What is required is a different view of the function of the mental hospital. When the treatment team decides that hospitalization often can and should be circumvented, and adopts prevention of admission as one of its primary functions, it will find practical alternatives to admission right at hand. The team will need a willingness to take responsibility for the patient's care promptly; a willingness to be flexible with regard to how and where treatment is to be given; and a willingness to consider together the patient, his family, and his environment in diagnosis and treatment.