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June 1977

The Long-Term Patient in the Era of Community Treatment

Author Affiliations

From the Department of Psychiatry, University of Southern California School of Medicine, Los Angeles (Dr Lamb), and the American Institute of Behavioral Sciences, San Jose, Calif (Dr Goertzel).

Arch Gen Psychiatry. 1977;34(6):679-682. doi:10.1001/archpsyc.1977.01770180065005

• 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, noninstitutional settings. The role of Supplemental Security Income (SSI) in enhancing adaptation of the chronically disabled was impressive to the research team.