Journal Article

Mental health outcomes before psychotropic medications: a retrospective case series of one state hospital records from 1945 to 1954

Love, Stephen, Sherman, David, Harrison, Jennifer, Chapleau, Ann

2023

Overview

Background Current outcomes for mental illness are widely regarded as poor. Since the introduction of psychotropic medications in the mid 1950’s, previous psychosocial practices were minimized in favor of medication focused treatment. The majority of large U.S. state hospitals have closed with records destroyed or in storage, inaccessible to researchers. This creates barriers to studying and comparing outcomes before and after this shift in treatment practices. Aims The study aim was to examine discharge outcomes in relation to length of stay and diagnosis in one U.S. state hospital. Methods This case series study examined 5618 medical records of participants admitted to one state hospital from 1945 to 1954, the decade prior to adoption of psychotropic medications. Results Of the 3332 individuals who left the facility, over half (59.87%) of first episode hospitalizations were discharged within 1 year, and 16.95% were hospitalized for more than 5 years. 46.17% of all admissions were discharged from hospital with no readmission. The most common diagnoses included schizophrenia, other forms of psychosis, and alcoholism. In the decade before the introduction of psychotropic medications, participants were often admitted for a single episode and returned to their homes within several years. Conclusions Although limited to one site, findings suggest that discharge outcomes prior to psychotropic medication as a primary treatment for mental illness may be more positive than previously understood.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Analysis / Digitization / Discharge status / Dosage and administration / Health Administration / Health Informatics / Health services / Historical research / Hospital Records / Hospitalization / Hospitals / Hospitals, State / Humans / Length of stay / Medical diagnosis / Medical records / Medicine / Medicine & Public Health / Mental disorders / Mental Disorders - diagnosis / Mental Disorders - drug therapy / Mental health / Mental health outcomes / Mental institutions / Nursing Research / Outcome Assessment, Health Care / Patients / Pharmaceutical industry / Psychiatric hospital care / Psychiatric hospitals / Psychiatric services / Psychosocial rehabilitation / Psychotropic drugs / Psychotropic Drugs - therapeutic use / Public Health / Research Article / Retrospective case series / Retrospective Studies / Safety and security measures / Schizophrenia / State psychiatric hospitals