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Biomedical subjects

R W Manderscheid

Publications and source records attributed to R W Manderscheid.

At least 55 records · Page 3Linked to original sources
PubMed1990

Patient care episodes in mental health organizations, United States: selected years between 1955 and 1986.

The 4,747 mental health organizations (excluding territories) providing mental health services in the United States during 1986 generated almost 7.9 million patient care episodes including those in Veterans Administration outpatient and partial care programs. However, in order to make comparisons between 1986 data and all years dating back to 1955, outpatient and partial care programs administered by the Veterans Administration (VA) are omitted. Thus the 7.5 million patient care episodes (exclusive of the aforementioned VA programs) represented a more than four-fold increase over the 1.7 million patient care episodes in mental health organizations observed 31 years earlier in 1955. The major shifts in patient care episodes over the 1955-1986 period have been from inpatient to ambulatory care services in mental health organizations, and from State and county mental hospitals to community-based mental health organizations. For example, in 1955, 77 percent were inpatient care episodes, and the remaining 23 percent were outpatient episodes; by 1986, inpatient care episodes constituted only 27 percent of the total, while 68 percent were outpatient episodes, and 5 percent were partial care episodes. Moreover, between 1955 and 1986, the primary locus of inpatient care episodes shifted from State and county mental hospitals to non-Federal general hospitals, and by 1986 over one-half of the outpatient care episodes and about two-thirds of the partial care episodes occurred in the multiservice mental health organizations.

Ambulatory Care↗
PubMed1989

Forensic mental health services provided by mental health organizations, United States, 1985.

Results from the 1985 NIMH Inventory show that 1,339 (43 percent) of the 3,118 mental health organizations surveyed provided mental health services to mentally disordered adult offenders. Almost three-fifths of these forensic services were in multiservice mental health organizations, 23 percent were in freestanding psychiatric outpatient clinics, 14 percent in State mental hospitals, 4 percent in private psychiatric hospitals, and less than 2 percent in residential treatment centers for emotionally disturbed children and freestanding psychiatric partial care organizations. About two-thirds of the 289 State mental hospitals provided forensic services; 55 percent of the 1,383 multiservice mental health organizations and 40 percent of the 756 freestanding psychiatric outpatient clinics offered these services. Psychiatric assessment was the forensic service provided by the largest number of mental health organizations. This was followed, in order, by consultation to law enforcement staff and attorneys, psychiatric outpatient care, monitoring of medication, emergency mental health care, inpatient/residential care, partial care, and emergency detention. About 200,000 mentally disordered offenders received psychiatric assessment services from mental health organizations; slightly over 100,000 were provided psychiatric outpatient care, and smaller numbers of clients received other types of forensic services. A total of 14,538 full-time equivalent (FTE) patient care staff were involved in the delivery of forensic services. In addition, State mental hospitals reported 4,525 FTE administrative and support staff serving forensic patients. Special funding for forensic services, totaling $639 million, was received by just over half of the mental health organizations with these services. About four-fifths of this funding came from State mental health agencies, with the remainder provided by sources such as State correctional agencies, State courts or other State sources, city/county jails, city/county courts, and other local public sources.

Forensic Medicine↗
PubMed1989

Private psychiatric hospitals, United States: 1983-84 and 1986.

In 1986, a total of 314 private psychiatric hospitals provided inpatient services in 47 States and the District of Columbia (D.C.); 114, outpatient care services in 35 States and D.C.; and 102, partial care services in 26 States and D.C. Between 1983 and 1986, the total number of inpatient, outpatient, and partial care episodes in these hospitals increased from 333,731 to 483,284. During the 1983-86 period, the number of private psychiatric hospitals increased from 220 to 314. Almost all of this increase occurred among hospitals operating on a for-profit basis. By 1986, these hospitals represented three-quarters of all private psychiatric hospitals. With the exception of small not-for-profit hospitals, all bed-size groups in private psychiatric hospitals increased between 1983 and 1986. The number of beds in private psychiatric hospitals increased 41 percent, from 21,474 in 1983 to 30,201 in 1986. Similarly, the number of inpatient additions increased from 164,732 to 234,663 in this period, and inpatients at end of year increased from 16,079 to 24,591. The number of outpatient additions increased by more than half, from 77,589 in 1983 to 123,355 in 1986, and the outpatients at the end of the year rose from 79,598 to 135,606 (70 percent). In the same period, the number of partial care additions increased from 5,642 to 8,820, and partial care patients at the end of the year rose from 3,218 to 3,856 (20 percent). In the 1986 year-end inpatient caseload, males slightly outnumbered females, and the patient population was predominantly white, non-Hispanic. About two-fifths of the patients were under age 18, slightly over half were age 18-64 years, and 8 percent were age 65 or older. Mental illness was the major disability, with alcohol and drug abuse a distant second. By comparison, a smaller proportion of patients were under age 18 in 1983 (31 percent), and a larger proportion were age 18-64 (61 percent). In outpatient and partial care services, a more even distribution of the sexes was generally observed. Proportionately fewer outpatients were under age 18, more were between 18 and 64, and fewer were diagnosed with alcohol and drug abuse, compared with inpatient services. Also, proportionately more outpatients were Hispanic. Concomitant increases occurred in the number of full-time equivalent (FTE) staff, as well as in the amount of money expended by private psychiatric hospitals. FTE staff increased from 42,202 in June 1984 to 58,912 in November 1986.(ABSTRACT TRUNCATED AT 400 WORDS)

Cross-Sectional Studies↗
PubMed1989

Care of persons with schizophrenia: a statistical profile.

This article presents the latest information available from the National Reporting Program for Mental Health Statistics on the distribution and characteristics of persons with schizophrenia served by organized, specialty inpatient, outpatient, and partial care mental health programs. Results are presented separately for persons under care at one point in time and for persons admitted over a 1-year period, in order to examine the potential for change in each type of care. Findings show that about 900,000 persons with schizophrenia were served in 1986; that inpatient and outpatient programs were relatively equivalent in total numbers served, but that considerably more patient turnover occurred in inpatient programs; and that partial care programs, although small, were evolving as a locus of care for persons with schizophrenia. Some variations were observed among the different types of organizations offering each type of care, and characteristics of clients/patients that could lead to changes in each type of care were evident. Overall, the findings present a useful composite picture of specialty mental health care for persons with schizophrenia. The need for longitudinal, prospective research is noted.

Adolescent↗
PubMed1989

Characteristics of community support program clients in 1980 and 1984.

Results from a survey of 1,053 clients enrolled in the community support program in 1984 were compared with data on 1,471 clients enrolled in 1980. In 1984 the percentages of males and blacks treated was larger than in 1980, and clients made increased use of private homes and apartments and relied less on supported living arrangements. Both the percentage of clients receiving federal income supports and clients' median income as a percentage of the national median declined between 1980 and 1984. Fewer clients with schizophrenia and more clients with affective disorders were treated in 1984 than in 1980, probably due to implementation of DSM-III. Nationwide, the number of clients in the program grew from 4,288 in 1980 to more than 350,000 in 1984. The preponderance of schizophrenia, unemployment, and history of hospitalization in the 1984 cohort suggests the program is meeting its goal of treating the most severely mentally disabled.

Adult↗
PubMed1988

National trends in use of psychotherapy in psychiatric inpatient settings.

The use of individual, family, and group psychotherapy at a national sample of state and county mental hospitals, private psychiatric hospitals, and psychiatric services in nonfederal general hospitals in 1975 and in 1980 or 1981 was studied. Patients with organic or alcohol-related disorders were generally less likely to receive psychotherapy than were those with schizophrenia. Patients' educational level, gender, or race did not appear to influence the use of psychotherapy, but older patients were less likely to receive psychotherapy, particularly group or family therapy. During the study period, the percentage of patients receiving psychotherapy at nonfederal public general hospitals rose dramatically and by 1981 was almost equal to or even a little higher than the percentages at nonpublic general hospitals and private hospitals, a sign that public general hospitals have made an impressive adjustment to their increased role in caring for the severely mentally ill.

Data Collection↗