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Build a better state hospital: deinstitutionalization has failed.

Abstract

The author cites increasing numbers of chronic, homeless, and neglected mentally ill people as evidence of the failure of deinstitutionalization and community care to live up to their promise to reduce chronicity, the need for long-term hospitalization, and even mental illness itself. He believes the state hospital system, despite having been maligned and nearly destroyed, has great therapeutic potential. It could provide extended care to acutely ill patients before they become chronically ill; restore the ability to pinpoint responsibility for patient care, which has been lost under community care; and provide a stimulating academic environment conducive to research into treatment of the mentally ill.

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BibTeXRIS

A Gralnick. 1985. Build a better state hospital: deinstitutionalization has failed.. https://doi.org/10.1176/ps.36.7.738

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Chronic Disease↗

The long-term effect of multidisciplinary back training: a systematic review.

STUDY DESIGN: Systematic review of randomized controlled trials. OBJECTIVES: To determine the long-term effect of multidisciplinary back training on the work participation of patients with nonspecific chronic low back pain. SUMMARY OF BACKGROUND DATA: Chronic low back pain is influenced by multiple factors. Multidisciplinary back training represents one of the options to take this multiplicity into account. So far, only evidence of the short-term effectiveness of this approach in terms of work participation is available. METHODS: Electronic databases were searched and the references of various articles were screened for relevant publications. Ten studies met the inclusion criteria. All included studies were evaluated for their methodologic quality. RESULTS: Five of the studies had a low methodologic quality. All high-quality studies found a positive effect on at least one of the 4 outcome measures used. Based on our criteria, effectiveness was found for the outcome measures of work participation and quality of life. No effectiveness was found for experienced pain and functional status. The intensity of the intervention seems to have no substantial influence on the effectiveness of the intervention. CONCLUSION: In the long-term, multidisciplinary back training has a positive effect on work participation in patients with nonspecific chronic low back pain.

Chronic Disease↗