The Length of Stay of Psychiatric Inpatients

The length of stay (L.O.S.) in psychiatric inpatient units has become increasingly relevant as external pressures for economic justification of this expensive treatment modality have reinforced clinical and research misgivings about possible adverse effects of hospitalization (Krishner 1982). In a country like India, where the number of psychiatric beds is 0.03 to 0.04 per thousand population, there is a great need to keep hospital stay short. In the past, mental hospitals offered only life long custody, restraints and seclusion. Even after the advent of antipsychotics, many large state hospitals remained poorly staffed, over crowded and occupied by many chronic patients for whom no active treatment had been available. The separation of these patients from their families, the distance from community of origin and the consequences of long term institutionalisation all contribute to the condition from which they suffer (Wing 1962). Due to the almost revolutional progress in the treatment of mental illness, modern mental hospitals have discarded old custodial outlooks and have converted themselves into therapeutic centres. Whatever be the nature of the mental hospital, there are a good number of chronic patients who stay a long time in them (WHO Report 1978).