The Chronic Psychiatric Out-Patient in a General Hospital Setting

Abstract

The review of 65 cases from our psychiatric out-patient clinic in the general hospital setting reflects the interaction of several factors in determining chronicity. Chronic patients tend to have a poorly developed ego structure, which often reflects family psychopathy, and is in turn reflected by impaired social skills and a limited capacity to recover after a severe life stress. Emotional turmoil is frequently manifested by psychophysiological disturbances. There is usually a long delay before correct diagnosis is made and referral for psychiatric management is arranged. In the past our psychiatric out-patient care was also unsatisfactory and was reflected chiefly by over - reliance on drugs and limited support. At present we provide a greatly improved psychiatric out-patient service, based on sound psychotherapeutic principles. This can serve as a model for other psychiatric out-patient departments. It is hoped that continuing education will influence our physician colleagues to earlier diagnosis in these special cases. The application of mental health principles in our community programs will help to strengthen family structure and reduce the toll of human suffering. The better utilization of our existing psychiatric skills offers the best hope for the reduction of our chronically ill population.