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Reid: Psychiatry and Law Updates HOME

Let's Create Real Help for People with
Severe & Chronic Mental Illness

There's a glaring, critical need for residential psychiatric treatment in the public sector. These comments offer practical suggestions that making progress clinically, socially, and politically.

In development as of January, 2013

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Journal of Psychiatric Practice

Guidelines for legal & clinical professionals



Acute care alone, with brief hospitalizations that barely alleviate immediate psychosis and quickly move patients to well-meaning but woefully inadequate, infrequent, outpatient care, occasional group homes, and, if the patient is extremely lucky, assertive community treatment programs (ACT, PACT) do not, and cannot, come close to meeting the needs of either patients or communities. The patient must deal with continuing symptoms of lifelong and severe mental illness, poor access to clinical follow-up and ongoing care (whether from lack of availability or an inability to independently and consistently seek out that care), uneven medication response, likely sporadic medication dosage or medication noncompliance, frequent medication side effects that encourage noncompliance, substance abuse, marked social deterioration and social isolation, dangers of physical injury and illness (often related to marginal living conditions), and (usually) petty crime. Each of these exacts a toll on the patient, his or her family, the community, and the local and regional economy.

Watch this space for a discussion of the great need for residential treatment for the severely and chronically mentally ill (SCMI), and some solutions that work, are supportive and humane, and bring huge dollar savings, social advantages, and personal benefit to chronic mental patients and their families.

Feel free to comment by clicking here: email Dr. Reid, but please remember that I cannot offer clinical or forensic comments online unless you are a bona fide clinical or legal professional, and I cannot engage in lengthy individual discussions.