Overview

There was a time, not long ago, when the only treatment options considered to be worthwhile for patients requiring psychiatric care were the 50-minute hour on the one hand, or full-time hospitalization on the other. Most of us were convinced in those days that treatment could, and indeed should, take place with a minimum of involvement by the patient's family. Nor did we really consider that the community in which a patient lived was a significant contributor to either his illness or its cure. These naive assumptions were strongly challenged, of course, be- ginning with the questions of social psychiatrists in the 50s and con- tinuing with the quiet growth of the patients' rights movement. Thus it is no mere coincidence that when the community psychiatry movement emerged in the mid-60s as a powerful force for profound change in our traditional practice, the concept of partial hospitalization, which can be traced back at least 30 years, became a symbol of the new social psychiatry. Partial hospitalization had singular advantages well attuned to the times: it did not force a separation between the patient and his family; it cost far less to deliver than inpatient care; and it avoided the stigma of institutionalization while still providing far more care than the traditional psychotherapeutic hour. In a few years' time, several well- controlled studies documented that virtually all patients who were cus- tomarily treated on an inpatient basis could be effectively managed and treated in a day hospital.

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