The state mental hospital in mid-nineteenth century America: A social analysis.

To determine the identity of a mental hospital, a case study of the development of a state hospital during its 1st 25 yr. is presented. The initial success of the hospital was due largely to the efforts of its leader who rejected supernatural interpretations of mental illness, and, while holding to a somatic pathology, accepted modifications that permitted a psychologically oriented therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Classifications and salaries of psychologists in state mental hospital systems.

Afour-and-a-half page table summarizes job classifications and salaries of psychologists in the state mental hospital systems of 42 states. The data were acquired by means of a 3-page questionnaire directed to the various mental hospital authorities. "Although functions within state systems vary, indications are that the psychologist continues to find his role in this facet of public service administratively defined as one in which psychodiagnostic skills are primary." Noteworthy, however, "was the extent to which active involvement of the psychologist was also anticipated in the treatment process, research, and teaching of other institutional personnel." 2 states "specified that candidates for their top level positions must possess an ABEPP diploma, and two more expressed the desirability for such… . Twenty-five… states evidenced some enhancement of salary in the form of maintenance or residential perquisites." Major headings in the table refer to: state, job title, educational requirement, professional experience, annual salary, and residential perquisites. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychologist and the small mental hospital.

A brief questionnaire was sent to the directors of the 82 hospitals belonging to the National Association of Private Psychiatric Hospitals. Replies were received from 49 or 60% of the sample of which 47 could be used for tabulation. "Only two hospitals say they do not use psychological tests; four more use them occasionally; one does not say; and the other 40, or 85% of our sample, gives an unqualified 'yes.' All those hospitals giving tests even occasionally, indicate the Rorschach as routine. All but two also list the Wechsler in this way." "Only 14 of the hospitals employ full-time psychologists. 23 more employ part-time psychologists." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Contingency control and shaping procedures to institute bedmaking behaviors in a state mental hospital.

By making cigarette smoking for the day contingent on bed making, the number of unmade beds on a locked psychiatric ward of a state mental hospital was reduced from 50%-10%. Of Ss who did not make their beds, only 1 found cigarette smoking to be enjoyable. Successive approximations were used to institute bedmaking in that S. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hemodilution in clinical surgery: state of the art 1996

Acute normovolemic hemodilution entails removal of blood from a patient either immediately before or shortly after induction of anesthesia and simultaneous replacement with cell-free fluid. Nowadays, because of their predictable volume effects, the synthetic colloids (6% dextran 60/70, 6% hydroxyethyl starch 200,000) are preferred as volume substitutes; albumin should be avoided because of its high cost. Hemodilution has experienced a renaissance in recent years, mainly due to the evolving discussion of legal aspects, immunologic changes, viral infections, and a potentially higher cancer recurrence rate associated with the transfusion of homologous blood. Hemodilution should be considered for elective surgical patients free of contraindications and presenting with an initial hemoglobin concentration >/= 12 g/dl and an anticipated blood loss of >/= 1500 ml. The efficacy of this method (judged by the need to give homologous blood transfusion) depends on the preoperative (initial) hematocrit, the target hematocrit (to which hemodilution is performed), and the preset intra- and postoperative transfusion trigger. In the past, data from clinical trials showed that in healthy subjects a target hematocrit of 20% to 25% (hemoglobin 7.0-8. 0 g/dl) is feasible and safe for the patient. The lower the target hematocrit accepted, the more extensive is the monitoring required: Intraoperative target hemoglobin concentrations of 5.0 g/dl and less have been tolerated by surgical patients without adverse effects. The safety and efficacy of acute normovolemic hemodilution in terms of reducing homologous blood transfusion requirements has been demonstrated in various clinical studies. Hemodilution therefore is regarded an integral part of programs aimed at reducing the need for homologous blood and can thus be successfully combined with preoperative autologous blood deposition, intraoperative blood salvage, and carefully adjusted surgical techniques. Hemodilution is feasible and relatively cost-effective, and it minimizes adverse effects associated with transfusion of homologous blood, particularly transmission of viral diseases, immunosuppression, and infectious complications.     

Community mental health centers and the decreasing use of state mental hospitals

Tryptophan was measured in the cisternal CSF and brains of rats. In untreated rats there was a significant but not very close correlation between the tryptophan concentration in these two compartments. Factors that change the brain tryptophan concentration such as starvation, glucose feeding, and lithium treatment affected the CSF tryptophan in the same way as the brain tryptophan. Diurnal changes were parallel for brain and CSF. When we take into account our knowledge of the disposition of tryptophan in human CSF, these data suggest that measurement of lumbar CSF tryptophan in man may be a useful approach to the study of human brain tryptophan. However, because the correlation between brain and CSF is not very close, measurements on CSF tryptophan would be more meaningful in groups of patients than in individuals.     

The forensic psychology section in a state hospital.

A psychology section functioning in a forensic services center is described. The legal questions that must be dealt with in such a setting are explained, and psychology's role in answering these questions is explored. The goals of treatment in a forensic unit, which focus on educating a defendant to competency for trial, are discussed, and an example of a treatment program is presented. The functions of a psychologist in a forensic setting are compared and contrasted with those of a psychologist in the general mental health field. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tracking the demise of state hospital rate setting

From its once preeminent position in state health policy, prospective hospital rate setting has declined in use from more than thirty states in 1980 to two today. This essay tracks the trend toward deregulation in various states--especially Massachusetts, New Jersey, and New York-- and examines the continuation of rate setting in Maryland. Principally, the decline reflects the development of managed care and capitation as alternative means to control health spending growth. This trend represents both an evolution in prospective payment methodology and a renewed preference for private over public-sector price controls.     

National hospital discharge survey: annual summary, 1996

OBJECTIVES: This report presents national estimates of the use of non-Federal short-stay hospitals in the United States during 1996 and selected trend data. Estimates are provided by demographic characteristics of patients discharged, geographic region of hospitals, conditions diagnosed, and surgical and nonsurgical procedures performed. Measurements of hospital use include number and rate of discharges and days of care, and the average length of stay. METHODS: The estimates are based on data collected through the National Hospital Discharge Survey (NHDS). The survey has been conducted annually by the National Center for Health Statistics (NCHS) since 1965. In 1996, data were collected for approximately 282,000 discharges. Of the 507 eligible non-Federal short-stay hospitals in the sample, 480 (95 percent) responded to the survey. Diagnoses and procedures are coded according to the International Classification of Diseases, 9th Revision, Clinical Modification, or ICD-9-CM.     

Some problems in the hospital management of criminal mental patients

In view of impending new legislation in Rhodesia, a survey of 256 criminal mental patients admitted to Ingutsheni Hospital was undertaken. These patients were all treated by the author and were admitted during the 5-year period 1 January 1970-31 December 1974. Among these patients there were 113 schizophrenics (44%) and 57 epileptics (22%); these proportions are not significantly different from those previously found among civil patients. The outcome was that 86 patients (33, 6%) were discharged to stand trial, 107 (41, 8%) were discharged in terms of a recommendation by the Mental Hospital Board and 57 (22, 3%) were returned to prison. Recommendations are made for the provision of a new forensic psychiatric unit, and some of its functions are discussed.     

The effects of state intergovernmental transfers on local public mental health services

The provision of public mental health services is shifting increasingly from states to local areas. Yet state governments continue to bear financial responsibility for the majority of these services. One implication of this trend is that the success of state policies become dependent on a state's ability to influence the behavior of local areas. This paper discusses the different options states have in designing intergovernmental grant contracts with local areas, and describes likely impacts of the different strategies. These propositions are then tested using data from the Ohio state mental health system from 1989-1993. This study finds that the design of grants affects public expenditures, local revenue generation, and the mix of services provided at the local level.     

The psychologist as front-line mental health consultant in a general hospital.

Describes the experiences and diverse functions of a psychologist who acts as an independent mental health consultant in a general hospital. Particular attention is paid to problems that arise when psyche and soma interface, because these problems require knowledge of biology as well as of psychology. The appropriateness of this role for the psychologist and its acceptability to referring physicians are examined. The particular strengths of the psychologist as a behavioral scientist and the need for continuing education in differential diagnosis when psychological and physiological factors interact are also explored. Professional boundaries and role relations between psychology and related professions are reviewed. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mirror self-recognition and mental state attribution.

D. J. Povinelli's (see record 1993-35769-001) experiments test only the predictiveness of whether chimpanzees but not monkeys have (perhaps) a limited form mental state attribution. Given that almost all primatologists believe that chimpanzees are smarter than monkeys in almost all ways, the experiments merely support widely held beliefs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An outcome index for mental hospital patients.

"An Outcome Index for mental hospital patients is described. The index relates time out of hospital to follow-up period since first admission and weights their ratio differentially by number of readmission and releases. This index becomes relatively stable on a 2-year follow-up. It can be used as a criterion for prognostic efficiency, for efficacy of treatment, and for characterizing institutional policy." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dyadic crisis suicides in mental hospital patients.

Studied 70 cases of completed suicide among male veterans: 50 "dyadic" (precipitated by disruption of interpersonal relations), and 20 controls (precipitated by nondyadic events). Case history and hospitalization factors, personality characteristics of both members of the dyad, characteristics of their interpersonal relationships, stresses immediately prior to the suicide, and patterns of dependency were related. The dyadic suicide group showed more (a) disordered social relationships, (b) suppression or rejection of significant others when young, (c) open dependence in varied areas, and (d) diagnoses of depression. Distinguishable, although overlapping, personality configurations emerged when the dyadic group was broken down into subgroups of strained, broken, and terminated relationships. It is concluded that the dyadic partner should be included in the treatment program of suicidal patients when the main problem is the relationship. (21 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)