Long-term hospital treatment: a 25-year study.

Findings from a 25-year study of admissions to a single long-term private psychiatric inpatient facility document a sharp decline in average age and an increase in concurrent diagnoses of substance abuse and personality disorders. In this case, long-term private inpatient care has survived the significant changes in mental health policy and funding practices of the past quarter century, but has shifted its focus from a more general psychiatric caseload to the seriously disturbed adolescent or young adult patient. There are numerous factors which determine every aspect of hospital treatment. Though some are easily determined, many are dimly defined and difficult to measure. At present, their effect on patient progress is obscure. These factors, discussed in some detail, may be internal and peculiar to an institution itself. A dialogue is initiated for the insight it furnishes about the changes that have occurred in hospital treatment.