Therapeutic Response and Length of Hospitalization of Psychiatrically Ill Veterans: Social Determinants

Some special features of veterans have already attracted psychiatric attention. Adler and Gates¹ concluded that the veteran patient perceives and exploits the collective guilt of the community over “sacrificing its sons” which is reflected in the compensation system, and that he becomes the “querulous recipient of benevolent care.” Brown² described the Veterans Administration as a “protective parent figure,” encouraging dependency and lengthy hospitalization, and reported that non-service-connected patients recover more rapidly and in greater numbers than those receiving compensation. In the hospital which was the locus of the present investigation, patients tended to use their self-government organization as a means of organizing defensive hostility to protect themselves against the threat of losing some passive-dependent gratifications.³

The present investigation grew from the observation that patients on the open psychiatric wards of a Veterans Administration general hospital could be roughly divided