Psychiatric rehabilitation and long-term rehospitalization rates: the findings of two research studies

Abstract

Two controlled studies at Fountain House examined the influence of psychiatric rehabilitation services on rehospitalization. Study I, initiated in 1959, followed 252 experimental and 81 control subjects for 9 years. Study II, initiated in 1964, followed 40 experimental and 34 control subjects for 5 years. Experimental subjects had Fountain House services available, while controls did not. Additionally, experimental subgroups received systematic reaching-out services: home visits, telephone or letter contact. Study II findings essentially replicated study I. Followup was 96--97 percent complete. Three quarters of controls were rehospitalized within 5 years. Experimental subjects receiving reaching-out services for 2 years had significantly lower rehospitalization rates for the first 5 years in study I and the first 2 years in study II. Rehospitalizations were delayed, not prevented. Study I experimentals receiving 2 years of reaching-out services spent twice as long in the community before rehospitalization and 40 percent fewer days in the hospital than controls. Study II experimental subjects were in the community almost three times longer than controls before rehospitalization. Half of study I experimental subjects attended less than 10 times. Experimental subjects receiving reaching-out services attended twice as often as those not receiving reaching-out services. Low or nonattending experimentals had almost identical relapse rates (77 percent) as controls (74 percent), while, of experimentals having 100 or more visits, 37 percent were rehospitalized.