Transfers from a general hospital psychiatric service to a state hospital

The authors investigated the marked decline in the number of patients transferred from an inpatient service of a general hospital to a state hospital during a 30-month period. The major reasons for transfer were unmanageable behavior, high risk of suicide or homicide, administrative considerations, and unremitting or deteriorating course. They found that administrative concern about three factors--the many problems of patients likely to be transferred, staff anxiety, and the relationship between the general hospital and state hospital units--can facilitate the decline in the number of patients transferred to a state hospital.