"Anyplace but the state hospital": examining assumptions about the benefits of admission diversion

UMMS Affiliation

Department of Psychiatry

Publication Date


Document Type



Community Mental Health Centers; Continuity of Patient Care; Crisis Intervention; *Deinstitutionalization; Emergency Services, Psychiatric; Hospitals, State; Humans; Mental Disorders; *Patient Transfer; United States


Health Services Research | Mental and Social Health | Psychiatric and Mental Health | Psychiatry | Psychiatry and Psychology


One function of contemporary psychiatric emergency services is to divert patient admissions from state hospitals. Underlying this mandate are a series of untested assumptions about the positive effects of admission diversion. The author examines these assumptions using data on inpatient admissions from a crisis intervention service. Although the service was successful in preventing first admissions to the state hospital, the rate of recidivist admissions increased. Inpatient treatment in general or private hospitals did not result in shorter lengths of stay or fewer bed days than state hospital treatment. Because patients could be sent to any of several hospitals, some located far from the catchment area, continuity of care and treatment in the local community were not advanced by diverting admissions from the state hospital.


Hosp Community Psychiatry. 1991 Feb;42(2):145-52.

Journal/Book/Conference Title

Hospital and community psychiatry

Related Resources

Link to Article in PubMed

PubMed ID