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Lee, Choi, Jung, Jang, Kim, and Park: Comparison between Users of Community Mental Health Services and Psychiatric Patients in Mental Health Related Facilities in Korea
Original Article

Korean J Schizophr Res 2013;16(2):51-61.

Published online: 17 January 2013

DOI: https://doi.org/10.16946/kjsr.2013.16.2.51

Comparison between Users of Community Mental Health Services and Psychiatric Patients in Mental Health Related Facilities in Korea

Soo Jung Lee, MPH1, Jung Kyoo Choi, MD2, Un Jin Jung, MD3, Hong-Suk Jang, MD, PhD4, Sunah Kim, PhD5, Jong-Ik Park, MD, PhD, LLM2, 6,

1Korea Suicide Prevention Center, Seoul, Korea

2Department of Psychiatry, Kangwon National University Hospital, Chuncheon, Korea

3Seoul Eunpyeong Metropolitan Hospital, Seoul, Korea

4Dr. Jang's Psychotherapeutic Clinic, Seoul, Korea

5College of Nursing, Yonsei University, Seoul, Korea

6Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea

Address for correspondence: Jong-Ik Park, Department of Psychiatry, Kangwon National University School of Medicine, 156 Baengnyeong-ro, Chuncheon 200-947, Korea Tel: 033-258-9171, Fax: 033-254-1376 E-mail: lugar@kangwon.ac.kr

      Revised 14 July 20136 September 2013       Accepted 16 September 2013

Copyright © 2013 Korean Society for Schizophrenia Research

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

This study was conducted to compare the characteristics of psychiatric inpatients in mental health related facilities and community mental health services-utilizing patients by diverse factors in Korea.

Methods

Questionnaires were sent via mail to 140 standard mental health centers from October to December of 2008. 64 facilities responded and data of 461 mentally disabled who are registered at and utilize the services of these mental health centers were analyzed. T-test and cross-analysis were performed to determine the differences in the averages of the variables and the discrepancy in ratios, respectively.

Results

Differences between longterm psychiatric inpatients and community mental health services-utilizing patients were seen in characteristics such as gender, age, type of medical coverage, family support systems, diagnosis, age of onset, duration of hospitalization, community-dwelling period, and clinical symptoms and functions. It was significantly short in length of stay in facilities in users of community mental health services with comparison to institutionalized patients.

Conclusion

The results of this study suggest that invigoration of community mental health services is an alternative that can help deter longterm hospitalization.

Keywords: Length of stay, Longterm hospitalization, Community mental health service, Community mental health center

REFERENCES

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Table 1.
Response rates and distribution of community mental health centers
District No. of mental health center Response rates (%) No. of responders % of responders
Seoul 13 72.2 87 18.9
Incheon 3 50 25 5.4
Gyeonggi-do 12 44.4 89 19.3
Chungcheong-do 5 38.5 35 7.6
Gwangju and Jeolla-do 13 81.3 85 18.4
Busan and Gyeongsangnam-do 8 42.1 68 14.8
Daegu 3 37.5 19 4.1
Gyeongsangbuk-do 4 80 25 5.4
Gangwon-do 2 66.7 18 3.9
Jeju-do 1 100 10 2.2
Total 64 461 100.0
Table 2.
Comparison of demographic and social characteristics between users of community mental health services and institutionalized patients
Users of community mental health services
 Patients in mental health related facilities
N=461
 N=2,253
Number % Number %
Sex
 Male 267 57.9 1506 66.8
 Female 192 41.6 747 33.2
 Unknown 2 0.4 0 0
Age (years)
 Below 20 5 1.1 19 0.8
 20-29 82 17.8 127 5.6
 30-39 158 34.3 445 19.8
 40-49 146 31.7 725 32.2
 50-59 47 10.2 589 26.1
 60 or older 8 1.7 321 14.2
 Unknown 15 3.3 27 1.2
Average 38.32 (SD=9.13) 46.91 (SD=11.66)
 Marital status
 Never married 335 72.7 1076 47.8
 Married/cohabitation 45 9.8 485 21.5
 Divorced, separated, widowed 79 17.1 557 24.7
 Unknown 2 0.4 135 6
Education
 Below middle school 76 16.5 926 41.1
 High school 235 51 804 35.7
 College 143 31 369 16.4
 Unknown 7 1.5 154 6.8
Type of medical security
 Medical insurance 206 44.7 674 29.9
 Medicaid (type 1) 193 41.9 1189 52.8
 Medicaid (type 2) 41 8.9 184 8.2
 None 6 1.3 44 2
 Unknown 15 3.3 162 7.2
Religion
 Have religion 297 64.4 1245 55.3
 No religion 153 33.2 819 36.4
 Unknown 11 2.4 189 8.4
Familial support
 Has family who can live with 203 44 1353 60.1
 Has family/relatives who can help if needed 101 21.9 309 13.7
 No family/relatives who can help if needed 146 31.7 363 16.1
 Unknown 11 2.4 228 10.1
Table 3.
Comparison of clinical characteristics between users of community mental health services and institutionalized patients
Users of community mental health services
 Patients in mental health related facilities
N=461
 N=2,253
Number % Number %
Diagnosis
 Schizophrenia 364 79 1,176 52.2
 Affective disorder 57 12.4 151 6.7
 Alcohol disorder 3 0.7 613 27.2
 Others 24 5.2 187 8.3
 Unknown 13 2.8 126 5.6
Age of disease onset (years)
 Below 20 271 58.8 195 8.7
 20-29 78 16.9 418 18.6
 30 or older 15 3.3 764 33.9
 Unknown 97 21 876 38.9
Average 13.92 (SD=8.15) 12.43 (SD=9.97)
Total number of admission
 None 23 5 0 0
 Once 87 18.9 281 12.5
 Twice 73 15.8 395 17.5
 3-5 times 133 28.9 664 29.5
 6 times or more 87 18.9 498 22.1
 Unknown 58 12.6 415 18.4
Average 4.02 (SD=4.43) 5.01 (SD=5.67)
Number of admission for 2 years N=205
 Once 116 56.6 909 40.3
 Twice 40 19.5 566 25.1
 3-5 times 23 11.3 281 12.5
 6 times or more 1 0.5 25 1.1
 Unknown 25 12.2 472 20.9
Average 1.57 (SD=0.96) 1.81 (SD=1.2)
Length of stay in facilities for 2 years (months) N=205
 Below 6 109 53.2 487 21.6
 6-12 47 22.9 311 13.8
 12 or more 37 18 1,077 47.8
 Unknown 12 5.9 378 16.8
Average 6.45 (SD=6.42) 15.07 (SD=8.82)
Length of stay in community before admission (months) N=1,994
 Below 6 85 18.4 548 27.48
 6-12 36 7.8 90 4.51
 13-24 44 9.5 69 3.46
 25-36 32 6.9 10 0.5
 36 or more 112 24.3 47 2.36
 Unknown 152 33 1,230 61.69
Average 43.25 (SD=56.73) 8.93 (SD=19.46)
Table 4.
Comparison of clinical status between users of community mental health services and institutionalized patients
Users of community mental health services Patients in mental health related facilities
N=461 N=2,253
Number % Number %
Risk of self-injury and violent behavior
 Absent (0 point) 316 68.5 1,021 45.3
 Slightly present (1 point) 122 26.5 761 33.8
 Frequently present (2 points) 21 4.6 293 13.0
 Unknown 2 0.4 178 7.9
 Prominent thought/perception disability
 Absent (0 point) 249 54.0 1,024 45.5
 Slightly present (1 point) 168 36.4 660 29.3
 Frequently present (2 points) 42 9.1 388 17.2
 Unknown 2 0.4 181 8.0
Memory/orientation disturbance
 Absent (0 point) 329 71.4 1,271 56.4
 Slightly present (1 point) 112 24.3 615 27.3
 Frequently present (2 points) 15 3.3 187 8.3
 Unknown 5 1.1 180 8.0
Odd behavior/prominent regression
 Absent (0 point) 348 75.5 1,376 61.1
 Slightly present (1 point) 93 20.2 528 23.4
 Frequently present (2 points) 15 3.3 158 7.0
 Unknown 5 1.1 191 8.5
Types of medication/dosage change or side effect/transient program
 Absent (0 point) 264 57.3 1,154 51.2
 Slightly present (1 point) 169 36.7 717 31.8
 Frequently present (2 points) 24 5.2 192 8.5
 Unknown 4 0.9 190 8.4
Somatic symptoms which need treatment
 Absent (0 point) 339 73.5 1,381 61.3
 Slightly present (1 point) 88 19.1 543 24.1
 Frequently present (2 points) 26 5.6 207 9.2
 Unknown 8 1.7 122 5.4
 Need of admission by total score
 No need for admission (below 2 points) 214 46.4 721 32.0
 Need of admission (2 points or more) 245 53.1 1,309 58.1
 Unknown 2 0.4 223 9.9
Table 5.
Comparison of functional levels between users of community mental health services and institutionalized patients
Users of community mental health services Patients in mental health related facilities
N=461
 N=2,253
Number % Number %
Appropriate eating
 Do not need help (0 point) 389 84.4 1,822 80.9
 Need some help (1 point) 64 13.9 209 9.3
 Can not do without help (2 points) 6 1.3 38 1.7
 Unknown 2 0.4 184 8.2
Personal hygiene
 Do not need help (0 point) 382 82.9 1,688 74.9
 Need some help (1 point) 74 16.1 314 13.9
 Can not do without help (2 points) 4 0.9 71 3.2
 Unknown 1 0.2 180 8.0
Communication/personal relationship
 Do not need help (0 point) 277 60.1 1,242 55.1
 Need some help (1 point) 166 36.0 650 28.9
 Can not do without help (2 points) 16 3.5 176 7.8
 Unknown 2 0.4 185 8.2
Visit to hospital/medication/insight
 Do not need help (0 point) 322 69.8 904 40.1
 Need some help (1 point) 114 24.7 706 31.3
 Can not do without help (2 points) 24 5.2 461 20.5
 Unknown 1 0.2 182 8.1
 Management of money
 Do not need help (0 point) 347 75.3 1,238 54.9
 Need some help (1 point) 93 20.2 540 24.0
 Can not do without help (2 points) 20 4.3 292 13.0
 Unknown 1 0.2 183 8.1
Public transportation/facility utilization
 Do not need help (0 point) 378 82.0 1,245 55.3
 Need some help (1 point) 64 13.9 485 21.5
 Can not do without help (2 points) 18 3.9 335 14.9
 Unknown 1 0.2 188 8.3
Level of function by total score
 High level of function (below 2 points) 298 64.6 952 42.3
 Middleleveloffunction (2points to 4points) 108 23.4 590 26.2
 Low level of function (4 points or more) 54 11.7 509 22.6
 Unknown 1 0.2 202 9.0
GAF score
 40 or less 17 3.7 650 28.9
 41-60 165 35.8 964 42.8
 61 or more 243 52.7 434 19.3
 Unknown 36 7.8 205 9.1
Table 6.
Assessment of users of community mental health services
Number %
Types of community mental health services∗
 Community mental health centers 455 82.0
 Community psychiatric rehabilitation centers (psychosocial rehabilitation program) 14 2.5
 Community psychiatric rehabilitation centers (vocational rehabilitation program) 14 2.5
 Assisted living facilities 2 0.4
 Welfare centers for the disabled 40 7.2
 Etcs. 30 5.4
Occupational status
 Yes 141 30.6
 No 315 68.3
 Unknown 5 1.1
Type of employment†
 Sheltered house 78 55.3
 Transient employment 17 12.1
 Supportive employment 22 15.6
 Competitive employment 21 14.9
 Unknown 3 2.1

∗ : plural reponses were allowed, † : responders were 141 persons who answered ‘yes’ at occupation status question

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