General Hospital Psychiatry and the Crisis of Modern Psychiatry
During the last 15 to 20 years psychiatry has gone through an in depth transformation which affects as much the practical aspects of the provision of services and teaching, as well as its own delimitation and definition of objectives. Still in 1965 the common agreement was that 5 beds per thousand inhabitants were needed for the in-patient care of psychic patients which, unfortunately, generally took part in large and isolated psychiatric institutions. Today the ideal number accepted is around 0.8–1 beds per thousand inhabitants and the emphasis is put upon brief hospitalizations in general hospitals, together with the provision of community services. Only a decade ago, the psychiatrist believed himself to be omniscient, competent on the most diverse human activities, none of which escaped his capacity to scrutinize the most arcane motives of human behavior. Society accepted him that way, proud and in a certain manner harmless, almost alienated behind the walls of the insane asylums or at the couch in the offices of the psychotherapists. Today most of the psychiatrists tend to retract the frontiers of their action and rediscover the medical roots of our discipline. However, while the excesses of hospitalization and the abuses of “psychiatrization” diminish, psychiatry grows in importance, in spite of some of our medical colleagues. The way we practice is transformed as well. A collaborative multidisciplinary work is essential in General Hospital Psychiatry, a work in which the teaching activities are directed towards the psychological training of general practitioners and specialists to deal with that huge mass of problems which we would never be able to take on, and for which psychiatry has developed simply applied technologies.
KeywordsPsychiatric Institution Average Stay Drug Induce Parkinsonism Liaison Psychiatry Psychoanalytic Treatment
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