Psychiatric Day Care in a Rural Area

Abstract

How do you provide day care or partial hospitalization for psychiatric patients in a sparsely populated rural area? How do you do it when you don't have funds for such a program? Our answer to both questions in the Upper Peninsula of Michigan is use volunteers and community-donated facilities. Some of the volunteers have grown to be excellent lay therapists. The Alger-Delta-Marquette Community Mental Health Center, Marquette, is the central clinic for three counties, an area of 4,000 square miles, with a population of 107,000 -fewer than 27 people per square mile. There is a smaller clinic 60 miles away in Escanaba, Delta County. The central clinic in Marquette also staffs a clinic two days a week in Alger County, 40 miles away. At one time, a city hospital in Marquette provided a day care program of partial hospitalization, but the Marquette area had too few people to make the service feasible, and, at $16 a day, few in the area could afford it. The clinic in Marquette had had some success arranging day care programs with the use of volunteered help and space in Alger and Delta Counties. We decided to try the same approach in Marquette, to replace