General hospital psychiatry: Overview from a sociological perspective *

Abstract

Statistical materials concerning psychiatric services in general hospitals are in short supply, so that much of what passes for established fact is based on anecdotal evidence. Public general hospital psychiatry is increasingly encumbered financially by the admission of patients who receive emergency psychiatric care in private hospitals and are subsequently transferred to public hospitals for more intensive treatment. General hospital psychiatry today shares a number of problems with the rest of psychiatry. Viewpoints concerning target populations tend to be extremely polarized and are characterized by persuasively worded arguments. Although general hospitals provide a variety of psychiatric services ranging from education, training, and community consultation to direct patient care, the major services discussed in the current literature are: inpatient care, particularly of a short-term nature, to people with both acute-onset illness and chronic disabilities, outpatient care, emergency services, and consultation and liaison services. Emergency psychiatric services in the general hospital setting are also profoundly affected by deinstitutionalization.