Theses Doctoral

Clients or Patients?: A Study of Boundary Crossing in a State Psychiatric Center

Ibrahim, Hussein M.

An increasing number of clients are seeking admission to state mental hospitals to satisfy non-psychiatric needs. The study describes this phenomenon, its possible causes and its consequences. The study draws profiles of these clients' characteristics, problems, needs, and level of functioning. Clients' expectations from the state hospital and differences between them and the hospital inpatient population are explored.

The study was conducted on a time sample of 100 clients who sought admission to a New York State psychiatric center. The client sample were found not in need of inpatient treatment and were referred to an emergency housing program. Data were gathered through structured and unstructured questionnaires, interviews with clients, staff, center officials, and the center's statistical and patients' records. Chi-Square Test and Spearman Correlation were used to test relationships between variables.

Study data indicated that: (1) The majority of clients were young, white, single, males, unemployed, educated below high school level, and were living with a relative or a friend at the time they appeared for admission. (2) Client's self assessment and staff assessment of clients' needs suggested that housing and financial aid were significant to more clients than psychiatric treatment. (3) Client's self assessment and staff assessments of individual client's level of functioning indicated that the majority of clients were able and willing to live independently in community settings. (4) The majority of clients sought admission to the psychiatric center expecting help with housing, financial and emotional problems in that order. (5) Client sample and patients admitted to the center during the same period did not differ significantly with regard to age, sex, race, religion and marital status. The two populations differed in admission status, educational level, employment status, and sources of referral to the Center.

The study recommended a clear boundary distinction of psychiatric and non-psychiatric services and that psychiatric admission be based on psychiatric rather than social factors. The study also recommended several policy and planning options in dealing with the problem. A major option was the initiation of local personal social service centers to service clients with non-psychiatric problems.


More About This Work

Academic Units
Social Work
Thesis Advisors
Kahn, Alfred
Ph.D., Columbia University
Published Here
May 26, 2015