Psychiatric Quarterly

High readmission rates by young adult patients to state hospitals represents a major service utilization problem for the public mental health system. By identifying those patients who have an increase risk for rapid readmission, effective community-based services could be developed to help reduce utilization of costly hospital services. A nonconcurrent prospective study of 210 first admission young adult patients admitted to a state hospital was conducted to ascertain the incidence of readmission within 180 days of discharge from the index admission (rapid readmission), and to establish relative risk for rapid readmission based on demographic, hospital utilization, and diagnostic variables. The cohort was partitioned into two subgroups: patients with no prior hospitalization, (NPH; N=119), and patients with prior hospitalization, (PH; N=91). Group comparisons revealedNPH patients had a lower readmission rate, had shorter hospital lengths of stay, and had a higher proportion on patients with personality or adjustment disorders. The relative risk for rapid readmission in theNPH patient group was greatest for nonwhite female patients (3.30) and for patients who had hospital length of stays between 4–15 days (1.76). In thePH patient group, the relative risk for rapid readmission was greatest for those patients with hospital length of stay <15 days (2.15). In both groups, patients with major mental illness were more likely to get readmitted. An association between hospital occupancy rate, the time of discharge from the index admission and readmission to the hospital, hospital length of stay, sex, race, or diagnostic category was not found.

The emotional disturbance of Puerto Rican immigrants who attempted suicide has been studied and its relation to the immigration situation evaluated. It has been demonstrated that the interruption and subsequent disturbance of the individual's social and cultural stability causes personality conflicts and emotional illness, out of which an atmosphere favorable to suicide can develop. One can clearly distinguish between two different immigration situations of a disturbing character. In the beginning, it is the sudden disruption of the familiar life situation and the social dislocation that cause a “hangover depression” after emigration; and, in the transition period of adapting, the change of social concepts and cultural values causes conflicts and disintegration of the family, leading to unhappiness and tension with trends toward suicide. The typical form of suicide attempt in all cases was the “suicidal fit,” which is a conversion reaction in a nonpsychotic individual. It has been pointed out that a relationship exists between suicide pattern and basic illness, out of which the suicide crisis develops. The technical aspect of the suicide attempt and its outcome is modified by the environmental situation.

“All too frequently these people are sent from agency to agency, given either third-rate service or none at all, and rejected so repeatedly that they dare not ask any more.” This quotation suggests that readers who have no particular interest in New York Statistics should not miss Part III, particularly the section entitled “Need for Energetic Advocacy.” In earlier sections the authors describe a clinic in which mentally retarded persons are screened to determine need for admission to state residential schools serving New York City. Other functions of the staff are described—e.g., the searching out and evaluation of community facilities where retardates and their families could go for help.

This study explored depressive problems in drug addicted patients. Subjects were 114 heroin addicted patients undergoing treatment in a V.A. hospital. The methods included intensive interviews, the MMPI, the Rotter ISB Test, a psychological diary, and observations. All of the self-report techniques used indicated that many of the patients were experiencing strong depressed feelings. This depression, however, was not as clearly evident in the overt behavior of the patient.