Experience in a District General-Hospital Comprehensive Psychiatric Unit

Abstract

It has been the policy of the British Department of Health since the mid-1960s to close the large mental hospitals in this country and replace them with comprehensive psychiatric services, based in district general hospitals. The most recent details of this policy have been documented in the publication Better services for the mentally ill (Department of Health and Social Security, 1975). The decision to adopt this policy has been based on a number of factors: 1. There is an obvious desire to dispense with the large, impersonal institution, frequently housing more than a thousand patients and often situated some distance from the community it serves. Instead there is to be a centrally situated service, convenient for, and identified with, the people using it. 2. Including psychiatric patients in a general hospital reduces the stigma that has for years been attached to the treatment of mental disorder. This results in better community relationships and greater public interest in such matters. 3. The therapeutic results claimed by existing psychiatric departments in general hospitals have seemed impressive. 4. The desire of psychiatrists to be identified with mainstream medicine has caused the staff of such departments to have close working relationships with their medical colleagues in other specialties and has promoted common interests. This has, in turn, led to a reidentification of psychiatric illness as an integral part of general medicine and has assisted in the management of cases that cross the boundaries of different specialties. There has also