The establishment of a rehabilitation service at Bellevue Mental Hospital, Jamaica, and an analysis of the first six months of operation of that service

ABSTRACT

A detailed account of dynamic and administrative aspects of setting up a Rehabilitation Unit in Bellevue Hospital has been described. 72 patients from the long-stay wards of Bellevue Hospital were admitted to this unit in the first six months of its operation. Of these, 61 had been discharged within the first eight month period under study. The average length of stay in the Unit was 69 days, although 45.7 percent of the patients had been discharged within 60 days. 69.5 percent of the patients admitted had been in Bellevue longer than six months. One patient had been in Bellevue for over 19 days. 48.2 percent of the admissions were male, and 69.4 percent were under the age of thirty-five. 75.4 percent of the patients were from social classes 4 and 5 and 83.4 percent of the patients had an admission diagnosis of schizophrenia. Appreciable clinical improvement was made by 84.7 percent of the patients. Of the 61 discharged patients, 22.9 percent were placed in jobs at the time of follow-up clinics. 43 patients were attending follow-up clinics regularly; of these, one patient died during the follow-up period, and one became socially destitute. Of the 11 of 72 patients still in hospital, 4 still had appreciable psychiatric symptoms, and 7 were well, but had a home and/or a job placement problem. The average lenght of stay of this group in the unit was 120 days. The maximum lenght of stay for patients was 154 days. These findings were discussed. It was concluded that a fully staffed 50 bed rehabilitation unit could treat adequately, 265 patients per year; i.e. a bed usage rate of 5.3 patients per year. Certain conclusions concerning the strategy for dealing with the problem of Bellevue Mental Hospital were made and presented (Summary)