Lost in the Wards: A Retrospective Study of Long-Term Psychiatric Hospitalization in a Tertiary Care Institute
Dr Shikha Khairwal¹, Dr Pratibha Gehlawat², Dr. Shipra Singh³, Dr. Deepak Kumar⁴
¹Post Graduate Junior Resident, Department of Psychiatry, IHBAS
²Associate Professor, Department of Psychiatry, IHBAS
³Associate Professor, Department of Psychiatry, IHBAS
⁴Professor, Department of Psychiatry, IHBAS
Background:
Despite a global shift toward community-based psychiatric care, long-term hospitalization remains common in low- and middle-income countries. Many patients remain admitted beyond the acute treatment phase due to systemic, social, and legal barriers. This study explores factors contributing to prolonged inpatient stays exceeding three months in a tertiary psychiatric institute in North India.
Aims and Objectives:
To analyze the socio-demographic and clinical profiles of long-stay psychiatric patients and identify reasons for continued hospitalization.
Methodology:
This retrospective study included 30 male patients admitted in a long-stay psychiatric ward at IHBAS. Data were extracted from case files using a semi-structured proforma, covering demographic details, psychiatric and physical comorbidities, treatment history, family or social support, legal status, and reasons for prolonged admission.
Results:
Patients were diagnosed with schizophrenia, schizoaffective disorder, intellectual disability, dual diagnoses, and comorbid personality disorders. Despite clinical stability in several cases, prolonged hospitalization was attributed to factors like abandonment, homelessness, lack of community rehabilitation services, and forensic involvement. Many were on clozapine, including those with treatment-resistant schizophrenia.
Conclusion:
Extended admissions are often the result of social and systemic challenges rather than active psychopathology. The findings underline the need for comprehensive discharge planning, supported housing, and intersectoral collaboration to ensure social reintegration and uphold the rights of persons with mental illness.
Keywords:
long-term hospitalization, schizophrenia, social reintegration, institutionalization, treatment-resistant schizophrenia.
SHIKHA
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