National trends in use of psychotherapy in psychiatric inpatient settings.

The use of individual, family, and group psychotherapy at a national sample of state and county mental hospitals, private psychiatric hospitals, and psychiatric services in nonfederal general hospitals in 1975 and in 1980 or 1981 was studied. Patients with organic or alcohol-related disorders were generally less likely to receive psychotherapy than were those with schizophrenia. Patients' educational level, gender, or race did not appear to influence the use of psychotherapy, but older patients were less likely to receive psychotherapy, particularly group or family therapy. During the study period, the percentage of patients receiving psychotherapy at nonfederal public general hospitals rose dramatically and by 1981 was almost equal to or even a little higher than the percentages at nonpublic general hospitals and private hospitals, a sign that public general hospitals have made an impressive adjustment to their increased role in caring for the severely mentally ill.

Correlates of acting-out behaviors among young adult chronic patients.

The authors studied how the abuse of alcohol and other drugs and the failure to take prescribed medications are related to behavior problems shown by young adult mentally ill persons at home and in the community. The study was based on information provided by case managers for 1,471 clients in the community support program (CSP) sponsored by the National Institute of Mental Health. The study found that alcohol abuse was strongly related to acting out among young CSP clients, but that drug abuse affected their behavior even more adversely. Failure to comply with prescribed medication regimens accounted for a considerable share of the behavior problems exhibited by the young clients, particularly acting out in the community. Age was found to have an attenuating effect on behavior problems. The authors emphasize the need to devise programs to meet the needs of young chronic mentally ill persons.