Mental health statistical note最新文献

Despite the decrease from 474,190 to 250,541 between 1970 and 1990 in the overall number of non-Federal psychiatric beds (excluding "scatter" beds in non-Federal general hospitals), the trend was by no means constant over time. Between 1970 and 1982, a period of rapid deinstitutionalization of State mental hospitals, the number of beds in all organizations combined dropped precipitously from 474,190 to 222,666, led by State mental hospitals which decreased from 413,066 to 140,140 beds. This was the height of the community mental health center movement and the prevailing view of mental health administrators was that persons with mental illness could be cared for better in the community, rather than at State mental hospitals, far from their homes. Thus, some hospitals closed altogether, and many others closed wards and units as part of the downsizing process. Contrary to a decrease in the number of beds in State mental hospitals during the 1970-82 period, the number of beds in other organization types, in particular private psychiatric hospitals and separate psychiatric services of non-Federal general hospitals, remained relatively constant. The net result was a substantial decrease in the overall number of non-Federal psychiatric beds. In the 1982-90 period, a different phenomenon occurred. The number of beds in State mental hospitals was continuing to decline, but at a slower rate from 140,140 to 98,789, while the number of beds in other types of mental health organizations, particularly private psychiatric hospitals and separate psychiatric inpatient services of non-Federal general hospitals, expanded somewhat.(ABSTRACT TRUNCATED AT 250 WORDS)

The demographic and diagnostic characteristics of inmates in State adult correctional facilities who received 24-hour hospital mental health care, residential treatment care, and counseling/therapy in 1988 are reported by State and by type of administrative auspices under which the services are provided. Rates under treatment for 24-hour hospital mental health care were highest for the youngest (under 18) and oldest (65 and over) age groups, for females, and for whites. For counseling/therapy, rates were also highest for the youngest, for females, and for whites, but they declined with age. Rates in residential treatment were highest for the young and old and for whites, but about equal for males and females. Primary diagnoses of major psychoses predominated in 24-hour hospital mental health care. In residential treatment, a comparatively small proportion of the caseload had major psychotic disorders and a comparatively large proportion had substance abuse and mental retardation diagnoses. In counseling/therapy, personality disorders predominated. Individual State figures vary widely on these characteristics, both within and between service auspice types.

State-by-State data concerning the sources of funding, expenditures, and staffing for mental health services in State correctional facilities are reported for 1988 from the first national survey of prison mental health services conducted by the Center for Mental Health Services. Among all States, the total annual funding per prison inmate for mental health services varied widely, ranging from $5.67 to $3,159.41 per inmate, with a mean of $469.67 and median of $303.48 per inmate. States that administered 24-hour hospital mental health care to prisoners solely through the Department of Corrections (DOC) also tended to fund all types of mental health services solely through the DOC. However, in States where the Department of Mental Health (DMH) had primary administrative responsibility for 24-hour hospital mental health care, funding sources for all types of mental health services available to prison inmates were more likely to be mixed--i.e., funded through DOC as well as through DMH and other administrative entities. Master's-level mental health providers outnumbered doctoral-level professionals by more than two to one. At both of these educational levels, psychologists were numerically the largest category of provider, followed by social workers among master's-trained professionals, and followed by psychiatrists among those with doctorates. The single largest category was mental health workers with bachelor's-level training or less; this group accounted for about 44 percent of all mental health staff on State prison payrolls.

State-by-State data concerning the administrative auspices, volume of use, and sources of funding and expenditures for mental health services in adult correctional facilities are reported for 1988 from the first national survey of prison mental health services conducted by the Center for Mental Health Services. In all States reporting, a total of 11,546 State prison inmates--about 25 per 1,000--were receiving 24-hour psychiatric inpatient or residential treatment care for a psychiatric disorder on September 30, 1988. During the month of September 1988, nearly 10 percent of State prison inmates (95.6 per thousand) received some form of mental health counseling or psychotherapy from a physician, nurse, psychologist, or social worker; about 5 percent (49.7 per thousand inmates) received monitoring or evaluation of a psychotropic medications regimen; and about 4 percent (41.7 per thousand inmates) received psychiatric assessment or psychological testing to determine their mental health or emotional status. In the majority of States, 24-hour mental health care was provided in a mix of psychiatric and prison hospital settings, both on and off prison grounds, through interagency agreements, or through a mix of interagency and contractual arrangements. Individual State figures vary widely on these characteristics, as well as on length of stay for 24-hour hospital and residential treatment care, both within and among auspice types.