Greenhill M H
Hosp Community Psychiatry. 1979 Mar;30(3):169-82. doi: 10.1176/ps.30.3.169.
Despite the network of community mental health centers, the general hospital has become the focal point for the delivery of mental health care in the U.S. The author presents an overview of the psychiatric unit in the general hospital, including its history, structure and function, and its relationship to the hospital itself and to the continuum of mental health services in the community. The units' goals are not clearly defined but appear to be crisis intervention, acute treatment, correction of decompensation, prevention of chronicity, and speedy return of the patient to the community; there is little attempt to serve chronic patients. Paradoxically, the psychiatric unit also does not serve the hospital it is part of, as it rarely accepts patients from medical-surgical wards. The author summarizes evaluation studies related to general-hospital psychiatric units and recommends, among other points, truly evaluating the effects of short-term treatment and eliminating the current competition for the shortest stay.
尽管有社区心理健康中心网络,但综合医院已成为美国心理健康护理的焦点。作者概述了综合医院的精神科病房,包括其历史、结构和功能,以及它与医院本身和社区心理健康服务连续体的关系。这些病房的目标没有明确界定,但似乎是危机干预、急性治疗、纠正失代偿、预防慢性病以及让患者迅速重返社区;几乎没有为慢性病患者提供服务的尝试。矛盾的是,精神科病房也没有为它所属的医院服务,因为它很少接收来自内科和外科病房的患者。作者总结了与综合医院精神科病房相关的评估研究,并提出了一些建议,其中包括真正评估短期治疗的效果,以及消除目前对最短住院时间的竞争。