[Aspects of work in a psychiatric hospital department in 1970].
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Since 1983 the Psychiatric Division, Telemark Sentralsjukehus, has had a multiprofessional committee for health education and information directed mainly at the public and the primary health and social services. The main projects have been a series of articles in a local newspaper, arranging "open days" for the public and contributing to the form and content of radio programmes. It is also important to be available to journalists. We have managed to cooperate with the media on psychiatric health education. This has not, however, reduced the interest of the press in bringing conflict-related news and scandal stories from the psychiatric field. Laws and regulations seem to give too little flexibility in health education. Physicians should be better educated on mass communication and how to cooperate with the mass media.
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A survey of all admissions of patients under the age of 65 years during the first 6 years of a General Hospital Psychiatric Department identified 16 'long-stay' patients (a year or more of continuous inpatient care) and 8 'medium-stay' patients (at least 6 months inpatient care in any period of a year). The most common diagnoses were organic brain disorders among long-stay patients, and affective disorders among medium-stay patients. There was no consistent accumulation of long-stay patients: those with functional disorders were usually discharged to hostel accommodation, while those with organic brain disorders died or were transferred to inpatient care in other hospitals.
The author describes a practical set-up for practising psychiatry in a non-psychiatric department of a general hospital. Initially, patients were seen on an unorganized basis, each time psychiatric advice was asked for. Subsequently, a meeting was held each week, with all the staff members (physicians, nurses, social workers...) and the same consulting psychiatrist. This meeting serves several purposes: clinical evaluation of patients, training of staff members, exchange of information between hospital departments, and choice of treatment. The different situations leading to admission and the diversity of clinical pictures are described. Appropriate answers are more likely to be provided if each staff member is assigned clear-cut responsibilities.
A survey of all admissions of patients under the age of 65 during the first 6 years of a District General Psychiatric Department without mental-hospital support is reported. Three high-uptake groups of in-patients were defined; the long-stay (12 months or more), the medium-stay (6-12 months), and the revolving-door group (more than three admissions in any period of 12 months). Identifying characteristics which distinguish between these groups were examined. During a 7-year period there was no accumulation of long-stay patients, and a striking lack of schizophrenic patients who remained in hospital for more than 6 months or who had more than three admissions in any twelve-month period. This was not accounted for by drift of the high-uptake groups out of contact with the service, but may be related both to the style of service provision and to the socially cohesive nature of the area under study. Local variation should be given due importance when community services are being developed.