Patient care episodes in mental health organizations, United States: selected years between 1955 and 1986.

The 4,747 mental health organizations (excluding territories) providing mental health services in the United States during 1986 generated almost 7.9 million patient care episodes including those in Veterans Administration outpatient and partial care programs. However, in order to make comparisons between 1986 data and all years dating back to 1955, outpatient and partial care programs administered by the Veterans Administration (VA) are omitted. Thus the 7.5 million patient care episodes (exclusive of the aforementioned VA programs) represented a more than four-fold increase over the 1.7 million patient care episodes in mental health organizations observed 31 years earlier in 1955. The major shifts in patient care episodes over the 1955-1986 period have been from inpatient to ambulatory care services in mental health organizations, and from State and county mental hospitals to community-based mental health organizations. For example, in 1955, 77 percent were inpatient care episodes, and the remaining 23 percent were outpatient episodes; by 1986, inpatient care episodes constituted only 27 percent of the total, while 68 percent were outpatient episodes, and 5 percent were partial care episodes. Moreover, between 1955 and 1986, the primary locus of inpatient care episodes shifted from State and county mental hospitals to non-Federal general hospitals, and by 1986 over one-half of the outpatient care episodes and about two-thirds of the partial care episodes occurred in the multiservice mental health organizations.