The evolution of mental health services: partial hospitalization as a case example.

Controversy exists regarding the current status, merits, and future of partial hospitalization. Originally conceptualized as one of the least restrictive modalities for treating acutely ill or highly impaired individuals in the community, these functions increasingly are being addressed by rehabilitation programs and assertive or intensive outpatient treatments. At the same time, third-party payers, such as managed-care firms, are extending coverage for the partial-hospital modality. We use the current debates about the merits of this modality to identify potential forces that impede and promote the evolution of mental health services. Specifically, we use this case example to illustrate four prevailing myths about the manner in which services evolve.