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June 1966

Responses of Patients to Termination of Treatment in an After-Care Clinic

Author Affiliations

From the University of Missouri, Department of Psychiatry, Kansas City Division, Kansas City, Mo, and Western Missouri Mental Health Center, Kansas City, Mo (Dr. Hornstra).

Arch Gen Psychiatry. 1966;14(6):644-650. doi:10.1001/archpsyc.1966.01730120084011

I N ESTABLISHED after-care clinics psychiatric treatment becomes for some patients a permanent feature of their lives. For these clinics, this results in a steadily increasing number of long-term patients. This phenomenon remains unaltered despite continuing implicit efforts toward termination of treatment by reducing the amount of medication and extending the time interval between appointments.

We are seriously concerned with the question of whether after-care is a service without a time limit, with death being the only means of separation from the clinic. Perhaps preoccupation with the proven advantages of these services (prevention of readmission to inpatient services, and shortening of the period of hospitalization) has obscured the problem of the "eternal" patient.

To probe this problem we decided to terminate the therapy of a number of long-term patients and to evaluate the validity of several traditionally held opinions. The first of these opinions relates to the commonly accepted concepts

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