Show Summary Details
Page of

Inpatient treatment 

Inpatient treatment
Chapter:
Inpatient treatment
Author(s):

Frank Holloway

and Lloyd, I. Sederer

DOI:
10.1093/med/9780199565498.003.0094
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2016. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 17 October 2018

‘Inpatient care is, from the research perspective, the Cinderella of contemporary mental health services’ (Szmukler and Holloway, 2001). Research on the day-to-day practice of inpatient care remains a step-child of psychiatry and a policy vacuum on the role of inpatient treatment characterizes our field today. In the majority of advanced mental health economies large mental hospitals and institutional care has been vanquished by deinstitutionalization that has produced vast numbers of inpatient bed reductions.

Deinstitutionalization was driven by many forces: empirical evidence about the harmful effects of large institutions on patients (Wing and Brown, 1970); a general social movement that emphasized the ‘community’ as a positive resource for helping people (Hawks, 1975); scandals surrounding institutional care (Martin, 1984); cost containment (Kluiter, 1997); concerns about the importance of patients’ liberties and quality of life (Peele and Chodoff, 1999); and improvements in treatment technologies, which included medication, rehabilitation, assertive community treatment, psychological treatments, and crisis care (Ramsay and Holloway, 2007). A consensus developed amongst user groups, government and policy makers, service managers, and practitioners that inpatient treatment represented if not a failure then a barrier to an evolving paradigm of comprehensive community care. However, carers, clinicians in inpatient services, and community mental health staff who recognize the limits of community care however well it is done remain sceptical of such an antihospital proposition.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.