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November 1980

Equity and Changing Patient Characteristics—1950 to 1975

Author Affiliations

From the Center for Health Studies, Institution for Social and Policy Studies, Yale University, New Haven, Conn (Dr Mollica); and the Brentwood Veterans Administration Medical Center, and the Department of Psychiatry, UCLA (Dr Redlich). Dr Mollica is now with Harvard Medical School, McLean Hospital, Belmont, Mass.

Arch Gen Psychiatry. 1980;37(11):1257-1263. doi:10.1001/archpsyc.1980.01780240055006

• The treatment patterns for psychiatric patients in a northeastern industrial community in 1975 are compared with treatment patterns in 1950. This survey is a follow-up of Hollingshead and Redlich's Social Class and Mental Illness.

Special emphasis is placed on current treatment settings for the patient groups that in 1950 were either totally excluded from psychiatric care or using the state hospital exclusively. In spite of an enormous proliferation in the range and number of psychiatric services available to inpatients in the community in 1975, these patients were still receiving much of their inpatient care at the state hospital. In addition, they were found in public inpatient and outpatient units characterized by low-intervention treatment and staffed by semiprofessional and nonprofessional clinicians. These survey findings raise equity issues for such "low-status" patients. The concept of equity is applied to the survey results to generate relevant social policy questions.