AUDIT OF NEW LONG-STAY PATIENTS IN A DISTRICT GENERAL-HOSPITAL

Objective: To describe the characteristics of ''new'' long-stay patien ts in a district general hospital psychiatric unit. Method: A ''new'' long-stay patient was defined as a patient aged 18 or more who on the census date had been in a district general hospital psychiatric ward f or longer than six months but less than six years. There was no upper age limit but patients with a primary diagnosis of dementia were exclu ded from the study. Information about each patient was obtained from m edical and nursing cases notes. Patients were interviewed by one inter viewer to determine their views on discharge from hospital. All the me mbers of the multi-disciplinary team were interviewed by one interview er to obtain their judgements about future accommodation needs of the patients. Results: ''New'' long-stay patients are typically single in their mid-forties with no supportive relatives. Most have a primary di agnosis of schizophrenia. They have a long psychiatric history and the majority had been in hospital between 6 months and three years. The p rinciple reasons for prolonged stay were persistence of active psychot ic symptomatology, schizophrenic defect state, poor social skills and antisocial behaviour. Conclusion: A group of ''new'' long-stay patient s have accumulated in Wolverhampton district general hospital psychiat ric unit, despite modern methods of treatment and the availability of a good range of rehabilitation facilities. They are a diverse group in cluding patients with a severe schizophrenic disorders, affective diso rders, personality disorders and organic disorders. Ideally, if these patients are to be placed in the community, rather than remaining as i npatients, then placement would need to be in specialised facilities l ike hospital hostels.