Description: In the Declaration of Independence, it is written: "We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness." Yet, ostensibly in the United States, this does not apply to individuals who suffer from mental illness. It is immoral how we in the U.S. treat people who suffer from psychiatric illnesses! There are many more people with untreated severe psychiatric illnesses living homeless on America's streets than are receiving care in hospitals. Approximately 90,000 individuals with schizophrenia or manic-depressive illness are in hospitals receiving treatment for their disease. However, there are between 150,000 and 200,000 individuals with schizophrenia or manic-depressive illness who are homeless, a number equivalent to the population of many major cities in the U.S. There has been a dramatic decline in psychiatric hospital beds over the past four decades, not due to a reduction in the number of mentally ill, but rather due to decreased funding. At the same time, approximately 10 percent of the individuals in our prisons have severe psychiatric disorders. Thus, approximately 218,000 individuals with severe psychiatric disorders are incarcerated in the nation's jails and prisons at any given time. This new book is not primarily about the above immorality. It is, as the editors' state, the "good news" of psychiatric hospital treatment. It is about the latest trends and developments in the field of hospital psychiatry. Written and edited by clinician-administrators in psychiatry, this book is an excellent resource on past, present, and future concepts regarding hospitals' involvement in the care of the mentally ill.
Purpose: The editors note, "Our hope is that this book will have an impact not only in improving care in hospitals that already provide needed treatment but also in expanding opportunities in new settings, both inpatient and nonhospital, to provide available and effective treatments, to do what we can and should do in the context of today's marketplace."
Audience: The intended audience includes clinicians, administrators, and trainees.
Features: The book opens with an excellent and informative chapter on the history of hospital psychiatry. Part 1 focuses on the hospital care of specific populations with chapters devoted to acute crisis stabilization, child and adolescent units, geriatric psychiatry units, eating disorder units, the trauma unit, psychotic disorders units, substance-related units, developmental neuropsychiatry units, ethnic/minority units, forensic units, state hospitals, VA hospitals, and consultation-liaison psychiatry services. Part 2 covers special clinical issues with chapters on the consumer perspective, working with families, safety issues, inpatient suicide, and discharge dilemmas. Continuum of care is covered in part 3 with chapters on residential programs for so-called treatment-resistant patients, for children and adolescents, hospital based emergency services, community mental health services, and day hospital/intensive outpatient programs. Part 4 reviews issues involved in administration and leadership, psychiatrists and psychologists, social and rehabilitation services, psychiatric nursing, the financing of care, risk management, quality indicators, EMR, and the design and architecture of psychiatric hospitals/units. The concluding chapter focuses on future trends for hospital psychiatry. Each chapter ends with relevant citations of the psychiatric literature.
Assessment: This is a helpful new and comprehensive book on hospital psychiatry. Clinicians, hospital administrators, and lawmakers, as well as all stakeholders, should be knowledgeable (as this book will help them to become) about the history and future role of the hospital in the care of patients suffering from psychiatric disorders. I highly recommend it.