This psychiatric epidemiology study following the Mount St. Helens volcanic disaster revealed a significant morbidity for psychiatric disorders. The increased prevalence showed a dose response pattern in three population groups. The findings are reported as relative and attributable risk for the two exposed populations as compared to a control group. Patterns of significant risk are presented for sex, age, and for victims with pre-existing physical illness. The research utilized a new criteria-based interview schedule for the identification of psychiatric disorders. The methodology is reviewed in the context of the controversies and assumptions within the field of behavioral response to disaster stress. There are important implications for public health planning and intervention.

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The impact of reducing length of stay on readmission rates was examined for privately insured patients treated on a traditional inpatient unit or in an alternatives program with a shorter stay and a continuum of acute care. Billing data were analyzed for length of stay and readmission rates for all admissions between 1985 and 1992 (N = 1,363). The traditional unit was reorganized in 1990 into the alternatives program. Although the program decreased mean length of stay from 20.2 days to 6.2 full-day equivalents, overall readmission rates did not increase (17.2 percent, compared with 18.6 percent for the traditional unit). Rates increased for a subgroup of patients with psychotic disorders (from 13.7 to 35.2 percent).