Schwartz S R, Goldfinger S M
Hosp Community Psychiatry. 1981 Jul;32(7):470-4. doi: 10.1176/ps.32.7.470.
A subgroup of chronic mentally ill persons who have had little or no state hospitalization and who are difficult to engage in existing systems of community care is emerging in major urban areas. Observations made at a large municipal general hospital indicate the patients are typically young, more likely to be male, and highly transient. They have frequent interactions with emergency psychiatric and crisis units, coupled with intermittent involuntary short-term stays in local inpatient units. They have few skills and virtually no natural support systems. Under stress they show disorders in reality testing, exhibit anger and depression, and are prone to impulsive aggressive and self-destructive behaviors. They are typically unwilling to voluntarily accept continuing care. There is a lack of fit between this group's characteristic style of interaction and existing community-based programs. The costs of this lack of fit, both in staff morale and inappropriate use of expensive services, make the exploration of approaches to these "new chronic patients" a matter of immediate importance.
在主要城市地区，正出现这样一群慢性精神病患者，他们很少或从未在州立医院住院治疗，且难以融入现有的社区护理体系。在一家大型市立综合医院进行的观察表明，这些患者通常较为年轻，男性居多，且流动性极大。他们频繁与急诊精神病科和危机处理部门打交道，还会间歇性地非自愿短期入住当地住院部。他们几乎没有技能，也几乎没有天然的支持系统。在压力之下，他们在现实检验方面表现出紊乱，会愤怒和抑郁，且容易出现冲动攻击和自我毁灭行为。他们通常不愿自愿接受持续护理。该群体特有的互动方式与现有的社区项目之间存在不匹配。这种不匹配在员工士气以及昂贵服务的不当使用方面所造成的成本，使得探索针对这些“新慢性患者”的方法成为当务之急。
