Trends in American mental health

Using the data collected by Hollingshead and Redlich in 1950 and their own recent data, the authors describe trends in the mental health field over a 25-year period. They found a marked increase in admissions and readmissions to inpatient facilities and a significant decrease in the average length of stay; a considerable increase in outpatient treatment services; a shift in major diagnostic categories from schizophrenia to alcoholism; an unequal allocation of services to young versus elderly patients; discharge of many chronic patients to nursing homes; the increased involvement of psychiatrists in administrative work and decreased time spent in direct patient care; and an increase in third- party insurance as a source of patient fees.