Acute and chronic psychiatric care: Establishing boundaries

Abstract

Despite advances in psychiatry, a proportion of those with mental illness have episodes of severe illness, and a few of these patients may attain only partial recovery. In this respect, mental illness is similar to physical illness and systems of acute and chronic care are essential. As mental health care financing and delivery systems undergo further flux and reform, we will require clear, consensually developed definitions of levels of care, especially because of the complexities created by a legacy of a 2-tiered, public and private mental health system. This paper first will offer definitions and examples of acute and chronic illness and care. We will also address certain problems inherent to such a classification. We will then consider principles of and potential plans for a system of financing and care for the chronically mentally ill. Two existing plans will be reviewed as illustrations of innovations in chronic care. As health reform changes the financing and delivery of care for the mentally ill, an opportunity exists to integrate public and private monies and services and to improve upon the care of the acutely and chronically mentally ill.

Increasing Social Support for Individuals with Serious Mental Illness: Evaluating the Compeer Model of Intentional Friendship

“…Symptoms were assessed with two measures: the Hopkins Symptom Checklist-25 (an abbreviated version of the Hopkins Symptom Checklist) (Derogatis et al 1974;Sederer and Dickey 1995), and the Colorado Symptom Index (Sederer and Dickey 1996;Shern et al 1994), a 15-item scale designed to add clarity regarding psychotic-spectrum symptoms that are not well measured by general symptom inventories. This global index score was calculated as described above.…”

Patterns of Mental Health Service Utilization and Substance Use among Adults, 2000 and 2001

“…Although the role of inpatient mental health treatment has changed greatly over recent decades, resulting in a shift from institutionalization to more outpatient community-based approaches, inpatient treatment still plays an important role. These services emphasize safety measures, crisis intervention, acute medication and reevaluation of ongoing medications, and (re)establishing the client's links to other supports and services (Sederer & Dickey, 1995).…”

A Review of the Admission System for Mental Disorders in South Korea

“…Patients or their guardians can request a trial for suspension of admission in family court, and a complaint procedure is provided through which they can appeal if they disagree with the trial proceedings or judgement. The inpatient treatment system, including the functioning of the hospitals, needs to be divided into separate units-acute care, recovery, and long-term care-based on the inpatients 'characteristics [21]. The environment, and level or type of care, will depend on multiple factors: severity of the person's mental condition, their physical health, and the type of treatment prescribed [22,23].…”