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The Psychiatric Inpatient Unit in a General Hospital: A Functional Analysis *

The Department of Psychiatry of the Montreal General Hospital was established by one of the authors (A. E. M.) in 1946. The first facilities were outpatient and consultation services, but within several years an inpatient service was established, followed by a part-time treatment centre. In addition to treatment activities the teaching of medical students and the training of psychiatric residents reflects the Department's association with McGill University. The psychiatric setting is an eclectic one, although the major orientation reflects psychoanalytic and psychological theories of behaviour. The therapeutic techniques have included brief and long-term individual psychotherapies, group and family therapy, milieu settings and the full variety of somatic therapies. Research has primarily been of a clinical nature, concerned with practical applications and modifications, which have reflected changing community requirements. Psychiatric units in general hospitals have become increasingly 'accepted'. In 1954 only 10 per cent of all general hospitals in the United States had such units although they were already admitting more than 50 per cent of all patients requiring psychiatric care for the first time (1). By 1961 psychiatric beds in general hospitals in the United States exceeded the number of beds in the mental hospitals (3).' Canadian developments were similar. However there have been few studies carried out on the actual functioning of psychiatric units. The Mount Sinai Hospital, New York, reported data obtained from 1,264 patients admitted between 1947 and 1957 (5). The present study was in progress at the same time and is