The severely mentally ill (SMI) patient group is perhaps the most difficult psychiatric patient group to treat, and is a group which utilizes an enormous number of mental health service resources in the U.S. There is, however, little information on this population which is both data based and generalizable to the nation as a whole. One source of such information is the NIMH Patient/Client Surveys (""""""""Sample Surveys""""""""). The first goal of proposed project is to analyze these Sample Surveys for 1986 and for previous years from a service system and clinical services point of view in order to better understand the mental health service system for the prototypic group of SMI, schizophrenics, and the services provided to them. Schizophrenics will be compared to a group of severely ill, but not chronic, patients (those with major depression), and those with conditions which are neither severe or chronic. The second goal is to use these data analyses to formulate policy analyses concerning the SMI, resulting a policy monograph. This project will utilize a two dimensional conceptual matrix, delineating (1) the level of data analysis (i.e., the service system, services, and clinical), and (2) trends over tim This conceptual framework will be used to guide both the data and policy analyses. The major research question will be whether there are variations in care (geographic, between facility types, or between patient groups), as an indicator of possible problems in care. Specific topics include deinstitutionalization, uninsured schizophrenics, and specific services and clinical treatments provided to schizophrenics. The results of this project will be a set of data analyses which will elucidate important issues with regard to the ca of schizophrenics, and related policy analyses which will inform the process of services delivery and program planning. The project will also point to areas in need of further research, and will provide directions as to future services and policy research.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Special Emphasis Panel (SRCM (05))
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University of Maryland Baltimore
Schools of Medicine
United States
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Thompson, J W; Belcher, J R; DeForge, B R et al. (1995) Trends in the inpatient care of persons with schizophrenia. Schizophr Bull 21:75-85
Belcher, J R; DeForge, B R; Thompson, J W et al. (1995) Psychiatric hospital care and changes in insurance coverage strategies: a national study. J Ment Health Adm 22:377-87
Thompson, J W; Weiner, R D; Myers, C P (1994) Use of ECT in the United States in 1975, 1980, and 1986. Am J Psychiatry 151:1657-61
Thompson, J W; Belcher, J R; DeForge, B R et al. (1993) Changing characteristics of schizophrenic patients admitted to state hospitals. Hosp Community Psychiatry 44:231-5