Pepper B
J Clin Psychopharmacol. 1985 Jun;5(3 Suppl):3S-7S.
Uninstitutionalized young adults with chronic mental disorders and social disabilities pose a new challenge in community psychiatry. These attention-seeking, help-rejecting young men and women spend most of their lives in the community and differ markedly from older deinstitutionalized chronic psychiatric patients. Many confound identification by their abuse of drugs and/or alcohol. Most deny their mental illness and make inappropriate use of mental health services available to them. Because of the different problems and aspirations of these patients compared to older chronic patients, treatment programs must be age segregated to address these differences. Young adult chronic patients are best helped via flexible, accessible, nonstigmatizing, team-oriented treatment programs. Some patients require long-term neuroleptic therapy at low maintenance doses. In addition to their role as the primary provider of psychiatric care to these patients, psychiatrists must act as advisors to families and community planners and as political activists to focus additional attention on community-based (rather than state hospital-oriented) programs.
患有慢性精神障碍和社会残疾的非住院青年成年人给社区精神病学带来了新的挑战。这些寻求关注、拒绝帮助的青年男女一生大部分时间都生活在社区中，与从精神病院出院的老年慢性精神病患者有显著不同。许多人因滥用药物和/或酒精而难以识别。大多数人否认自己患有精神疾病，并不适当地利用为他们提供的心理健康服务。由于这些患者与老年慢性患者相比存在不同的问题和期望，治疗方案必须按年龄区分，以应对这些差异。通过灵活、便捷、无歧视、以团队为导向的治疗方案，能最好地帮助青年慢性患者。一些患者需要低维持剂量的长期抗精神病药物治疗。除了作为这些患者精神科护理的主要提供者外，精神科医生还必须充当家庭和社区规划者的顾问，以及政治活动家，以便将更多注意力集中在基于社区（而非以州立医院为导向）的项目上。
