The role of the hospital in the course of schizophrenic illness

Schizophrenics have the longest hospital stays and incur the greatest costs with respect to psychosocial care compared to other psychiatric patients. The present study focuses on-the relevance of inpatient treatment during th e course of schizophrenia with regard to specific symptom characteristics. In addition, the role of the hospital in partnership with local community h ealth care facilities for the care of schizophrenic patients is described. Central aspects of hospitalisation, such as the circumstances of first admi ssion, involuntary treatment, discharge planning, and provision for readmis sion are analysed and linked to our own data. Schizophrenic patients compri sed the largest group of involuntarily treated patiens and only 50% said th ey would return voluntarily to hospital if their symptoms recurred. On disc harge from hospital, schizophrenic patients did not differ from other psych iatric patients with regard to their attitudes to hospitalisation. Improvem ent in both work and interpersonal skills was evident after first inpatient teatment. To provide better care for this group of patients, patient-oriented health provision services with individual attention, treatment and care planning a re needed, in contrast to the more traditional hospital-oriented approaches that have been tending to give priority to institutional needs.