Are patients sicker?

[debi49]

I haven't done hospital inpatient psych for 15 years.....doing long term psychiatric care now with very stable, high functioning residents. I am thinking about trying to get back into the hospital setting, but my question is, ....Are patients sicker now than they were 15 years ago? Are they more acute? Stay longer? Less options for discharge? For those who have been in Hospital psych for a long time, what do you think? How have things changed in the last 15 years?

[Davey Do]

Interesting observation, debi49!

Having worked in Psych off and on for the past 30+ years, I would have to say yes, Psych Patients admitted to Community Hospitals generally manifest more intense symptoms nowadays. High Functioning Patients in Community Hospitals have dwindled in numbers.

There seem to be more Psych Patients in Community Hospitals with less financial resources. A vast number of those Patients, primarily with Psychotic diagnosis, were once admitted to the Civil Side of the State Hospital, are now admitted to Community Hospitals.

A combination of decreased Insurance Benefits and Government Facilities could be responsible for this trend.

[nickfitz1969]

I believe that finances might only be a small part of the issue. One might consider that the increased use of higher doses of psycho-active medication or length of time that patients are being prescribed questionably beneficial 2nd generation atypical antipsychotics as being a significant reason for the growth in mental illness and acute unwellness.

One might also consider the drug-induced super-sensitivity psychosis hypothesis caused by a variety of factors including medication withdrawal. I would encourage all clinicians to review the "Mad in America" website where new and exciting ideas might be obtained! So, I would argue that it's not all about the money!!