CHARACTERISTICS OF THE NEW LONG-STAY POPULATION IN AN INNER MELBOURNEACUTE PSYCHIATRIC-HOSPITAL

Objective: There has been an accumulation of so-called 'new long-stay' (NLS) patients in psychiatric hospitals. To date, no Australian studi es have characterised this patient group. We aimed to study the demogr aphy, and clinical and social functioning of the NLS population at Roy al Park Hospital (RPH) together with patients' attitudes to treatment and views on future placement. Method: All 30 NLS patients at RPH were identified. Twenty-seven consenting patients were assessed using the following standardised instruments: Manchester Scale for psychopatholo gy, Life Skills Profile (LSP), Physical Health Index and Patient Attit ude Questionnaire. Information on past psychiatric history, past treat ment and current treatment was collected. Insight and compliance were assessed. Results: The majority of patients were single men with a dia gnosis of schizophrenia. Forty-one percent were detained in hospital i nvoluntarily and 56% were considered dangerous to themselves or others . The patients were characterised by high levels of positive and negat ive symptoms. They were most impaired with respect to 'social contact' relative to the other subscales of the LSP. While 10 (48%) patients e xpressed a desire to leave hospital, only one patient considered that anyone would cohabit with them. Over two-thirds considered they had be en unwell and that medication had helped. Staff rated one-third as hav ing major problems with compliance. About two-thirds of patients had d isability secondary to comorbid physical illnesses. Conclusion: Like o ther NLS patients studied in the United Kingdom and Ireland, this grou p had significant handicaps secondary to psychiatric illness, concomit ant physical illness and disability and behaviour unacceptable in comm unity settings. They were also characterised by significant social iso lation. These factors may be important determinants of rehabilitation failure and need to be addressed in the process of de-institutionalisa tion as well as in longitudinal studies examining these and other fact ors predicting NLS status.