Day-hospital and community treatment for acute psychiatric illness. A critical appraisal.
Findings on the efficacy of day-hospital and community treatment for acutely ill psychiatric patients have been contradictory. This review confirms the methodological problems previously noted, but highlights the variation in feasibility of day care: staffing levels and the attitudes of staff appear to have been responsible, along with the severity and chronicity of illness. The comparison of day and in-patient care to see which is 'superior' has been unrewarding, and further research is needed. Day-hospital treatment is unlikely to be more widely used for acutely ill patients until: (a) there is clear evidence that certain patients are best treated in this way; (b) the social and clinical characteristics of such patients are defined; (c) adequate staffing is achieved (i.e. day care is not regarded as a cheap option); and (d) day centres are available for chronic patients.
Creed
F
F
Department of Psychiatry, Manchester Royal Infirmary.
Black
D
D
Anthony
P
P
D003156:Community Mental Health Services; D003631:Day Care, Medical; D003688:Deinstitutionalization; D004739:England; D006801:Humans; D001523:Mental Disorders / Q000534:rehabilitation*