Long range studies of mental hospital patients, an important area for research in chronic disease.

The resource that I should like to discuss is the mental hospital. Since mental hospitals are not usually operated by the department of health and the admission and follow-up of discharged mental hospital patients are usually not functions of the health department, I will spend a few minutes describing the characteristics of the populations of these institutions. This discussion, I am sure, will show that the hospitalized mentally ill constitute a major chronic disease problem, and merit a comprehensive research effort. In the United States there are 207 state, 50 county and city, 225 private hospitals for mental disease as well as the 34 VA neuro-psychiatric hospitals. The persons admitted to these hospitals are those with the more serious mental diseases, primarily the psychoses. They constitute a major illness problem for the nation because of their large numbers and the amount of care they require. The cost of their hospital care is prodigious. Combined, these hospitals spend more than $500,000,000 annually for maintenance and care of patients. Mental hospitals serve a dual function. Their primary functions are treatment and cure. If treatment fails, the hospital acquires the function of a domicile for the chronic patient. Emphasis is usually placed on the intensive treatment of newly admitted patients since they represent the most hopeful cases. However, an increasing amount of attention is being paid to the chronic patient and it has been shown that intensive treatment of this group can also be considerable. The chief stumbling block to intensive treatment for all types of patients is the extreme shortage of medical and nursing personnel in these institutions.