Sociodemographic and Clinical correlates of the Frequently Hospitalized African American Patients with Severe and Persistent Mental Illness

Abstract

Background

Many researchers and clinicians are becoming increasingly concerned about the phenomenon of frequent psychiatric inpatient hospitalization in those with severe and persistent mental illness. This study aims to shed light on this occurrence in the African American psychiatric inpatient population by examining their sociodemographic and clinical correlates.

Methods

We retrospectively reviewed the medical charts of 39 African American patients who have had ≥3 inpatient psychiatric admissions in a year at Howard University Hospital, an urban, academically-affiliated hospital serving a predominantly African American population in Washington, DC.

Results

Most frequently readmitted African American inpatients were male (62%), unmarried (95%), homeless (62%), intoxicated at admission (90%), unemployed (97%), and age ≥35 (87%); expressed suicidal ideations (85%); had a DSM-5 diagnosis of a psychotic spectrum disorder (59%) and less than fair insight into their illness (56%); and stayed in the hospital for ≤4 days (82%).

Conclusions

Many lessons can be learned from this study on African American psychiatric inpatient treatment recidivists, despite the work's limitations. Among these lessons are the need for strong case management, creative aftercare planning, and well-orchestrated, multifaceted services focused on these sociodemographic and clinical correlates— especially homelessness, unemployment, substance use, mood dysregulation, and psychosis—to successfully meet this patient populations’ clinical needs.