Specialist care for acute psychiatric disorders such as schizophrenia, chronic anxiety disorders, bipolar disorders, mood disorders, major depression, dementia, mental retardation and amnesia is usually provided by community teams supported by out-patient, day-patient and in-patient facilities. The type of provision depends on the severity of the disorders and whether the patient might be dangerous to himself/herself or others or where the symptoms are so severe that the patient is unable to care for himself.
There are various types of provisions for acute specialist care. These include:
Clinic or hospital: In a clinic or hospital, as opposed to an individual practice setting, a wide range of medical, psychological and social work procedures may be used. These range from the use of drugs to individual or group psychotherapy and to home, school or job visits aimed at modifying adverse conditions in a client’s life. For instance, helping a teacher become more understanding of a child client’s needs. Often the latter is as important as treatment directed toward modifying the client’s personality makeup, behavior or both. In this type of setting various tests and procedures such as electroconvulsive therapy (ECT), insulin coma therapy, neurosurgery, psychopharmacology and psychotherapy can be carried out with ease. Team approach is one of the key components for assessment and treatment, particularly in a group practice and institutional settings. This approach ideally involves the coordinated efforts of medical, psychological, social work and other mental health personnel working together as the needs of each case warrant. This approach integrates family and community resources in the total treatment approach.
Home based care: This aims at the assessment and treatment of patients in their home. This is used for treating patients with less severe disorders. A persistent concern with hospitalization is that the mental hospital may become a permanent refuge for the patient from the outside world as it offers total escape from the demands of everyday living or because it encourages patients to settle into a chronic sick role with a permanent excuse for letting other people take care of them. Over the past three decades there has been in considerable effort in encouraging the treatment of maximum number of patients at home. This also focuses on returning the patients to the community and on preventing a return to the institution. Hospital staff tries to establish close ties with the patient’s families and communities and try to provide them with positive expectations about the patient’s recovery.
