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Determinants of the Decision for Psychiatric Hospitalization

Werner M. Mendel, MD; Samuel Rapport, MD
Arch Gen Psychiatry. 1969;20(3):321-328. doi:10.1001/archpsyc.1969.01740150065010.
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IN THE recent history of American psychiatry, the use of the hospital as a therapeutic intervention in the treatment of mental illness has been seriously questioned. Studies by Lafave,1 Mendel,2 and Pasamanick3 have shown that patients who are treated without the use of the hospital in the management of their acute and chronic illness tend to display less morbidity and make more satisfactory extramural adjustment than those who have been hospitalized. As a result of these studies and the general recognition of the antitherapeutic effects of prolonged and inappropriate hospitalization, much emphasis has been placed on the clarification of the indications for hospitalization. It is generally agreed, even by the most conservative thinkers in psychiatry, that the patient should not be hospitalized simply because he is mentally ill or because the decision maker does not know what else to


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