The Social Breakdown Syndrome in a Cohort of Long-Stay Patients in the Dutchess County Unit, 1960-1963

Abstract

The establishment of the Dutchess County Unit was predicated on the opinion that "chronic hospitalization and disability can be reduced by . . . a comprehensive psychiatric service based upon a small, community-oriented, open public mental hospital [providing] maximum continuity of care. . . .1 It was believed that such a reduction in chronic hospitalization and disability could be achieved among the long-stay patients from Dutchess County already in the Hudson River State Hospital when the Unit opened. Consequently, the majority of these patients were transferred into the buildings housing the Unit shortly before it opened, and later, as beds became available, most of this group came into the Unit. One segment of the evaluation studies is concerned with estimating the effect of the Unit on the behavior and functioning of this cohort of long-stay patients. Initially, two hypotheses were developed: 1. that more Dutchess County residents on long-stay services in the hospital in October 1959 would be rehabilitated to the extent of being able to leave the hospital; and 2. that the long-stay patients would come to function at a higher level and be less deteriorated than if the Unit had not been established.