The Long-Term Patient in the Era of Community Treatment

Post hospital follow-up studies do not encompass the total population of long-term, psychiatrically disabled patients in the community, because a large proportion (in this study, 64%) have not had a recent hospitalization, either state or local. The authors identified a population of long-term, psychiatrically disabled patients in the community, all of whom carried functional psychotic diagnoses. Long-term disabled patients generally lead inactive lives, but in California seldom return to state hospitals. One third have been hospitalized locally within the past two years-younger patients much more than older patients. Almost half use private (Medicaid) outpatient services, but one fourth receive no mental health services at all. Less than a third live in board and care homes or cheap hotels; most live in nonsegregated, noninsitutional settings. The role of Supplemental Security Income (SSI) in enhancing adaptation of the chronically disabled was impressive to the research team.