Although short-term hospitalization has been shown to be effective in helping severely impaired psychiatric patients improve, such improvement is for some only temporary. Young, treatment-refractory patients who have failed to respond to previous brief hospitalization and outpatient treatments may benefit more from longer-term hospitalization. The authors report on a three-and-a-half-year follow-up study of 55 young adult and adolescent treatment-refractory inpatients after long-term hospitalization. Significant improvements in recidivism, quality of life, and overall functioning were found between discharge and the follow-up assessment. The authors conclude that potential benefits of long-term hospitalization for this subgroup warrant further empirical study.