PROBLEM
During the past several decades many changes have occurred in the delivery of mental health services. One of the most dramatic of these changes has been the move away from prolonged hospitalizations and toward shorter hospital stays coupled with increased availability of post-hospital services in the community. Although this change has been hailed by many mental health professionals as very desirable, there is some evidence that a large proportion of patients treated in shortterm facilities experiences repeated rehospitalizations ( 3 , 4 ) . Such evidence can lead one to question whether any significant changes in patient behavior and adjustment really occur in the short-term hospital.
I n a comprehensive study of patient changes during short-term hospitalization, Konick, Paolino, et al. ( 6 * 7 -8, have demonstrated that most patients showed significant reduction in psychiatric symptomatology according to ratings by nurses and psychiatrists. Further, the changes were more pronounced for some wards in a hospital than for other wards in the same hospital. The major purpose of this study was to determine whether short-term hospitalization was associated with changes in adjustment when self-ratings were utilized as a criterion rather than ratings by others. The study also sought to determine whether changes differed according to the particular ward in which the patient was treated. The MMPI was chosen t o give a patient-based measure of change because of its objective scoring, its wide-spread clinical use, the vast amount of research data available, and the feasibility of testing large numbers of Ss efficiently.
METHOD
Study Setting. The study hospital was a 262-bed, state-supported facility in a large metropolitan city. The individuals served by the hospital were quite varied, with a large proportion that consisted of lower social class and minority group patients. The average hospital stay was quite short (median = 53 days), with the more disturbed patients transferred to prolonged-care facilities. However, approximately 87% of admitted patients were released directly to the community. The major treatment modality was chemotherapy, although the hospital provided recreational and social activities for most patients and psychotherapy and related procedures for some patients. While the hospital maintained a day hospital, followup services for ex-patients, and an outpatient community clinic, its primary treatment came through its 10 hospital wards. Four male wards and six female wards each housed from 24 to 29 patients. With the exception of one male and one female ward, which were reserved for patients with medical problems, patients were assigned to wards on a random basis.
Subjects. All admissions to the study hospital for a period of 18 months were potential Ss for the study. Of 1,449 patients studied as part of a larger research project, the 376 included as Ss in this study were those who produced valid MMPI protocols at the time of admission and again at the time of discharge.'B2 The Ss