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Social and Psychiatric Problems in Day Hospital Management At Hill End

a psychoneurotic orientation at general hospital units (13) and newer small mental hospitals(9). The purpose of the present study is to describe the operation of the Hill End Day Hospital. There, attempts have been made to provide a comprehensive service. Since 1958, when the unit was planned as a pilot scheme, it has been housed in the limited space of the ’Superintendent’s House’ at the entrance to the mental hospital (760 beds) in St. Albans. The hospital has a catchment area of 300,000 persons and there is no other in-patient or day-patient provision for them. After-care is often provided by general practitioners as well as psychiatric out-patient domiciliary personnel who work in conjunction with the mental hospital and its day hospital. The day hospital provides a service on five days (9 am 5 pm, Monday to Friday) only, and most patients from the large semi-rural area reach there by ambulances. At the time of the study the full-time staffing at the day hospital consisted of