Koshes R J
Department of Psychiatry, St. Elizabeths Hospital.
Mil Med. 1991 Mar;156(3):121-6.
This paper reviews the phenomenon of homelessness in the United States and locally in Washington, D.C. Prevalence data of psychiatric illness in the homeless is presented, as is the formation of a psychiatric service network to treat the homeless mentally ill. Additionally, the author describes the development of an innovative training program in community psychiatry, focusing specifically on issues inherent in understanding the work of the psychiatric resident in community-based training and service delivery. The relevance of this experience to military medicine involves training psychiatric residents to develop service-delivery schemes in times of rapidly expanding mental health needs, such as combat.
本文回顾了美国及华盛顿特区当地的无家可归现象。文中呈现了无家可归者中精神疾病的患病率数据，以及为治疗无家可归的精神病患者而形成的精神科服务网络。此外，作者描述了社区精神病学创新培训项目的发展，特别关注在理解社区培训和服务提供中精神科住院医师工作所固有的问题。这一经验与军事医学的相关性在于，培训精神科住院医师在心理健康需求迅速增长的时期，如战斗期间，制定服务提供方案。
