Neal L. Cohen

Taking the suspected mentally ill off the streets to public general hospitals.

Unlike specialists in other areas of medicine, psychiatrists are often faced with having to treat patients against their will. Lack of awareness of their illness and lack of motivation to seek trea...

Law, policy, and involuntary emergency room visits

The authors present data showing that the number of mentally ill individuals brought by police officers to psychiatric emergency rooms in New York City increased by 69 percent from 1983 to 1989. They conclude that while the statutory criteria for the involuntary removal of mentally ill persons to hospitals have not changed, case law decisions and public policies that facilitate the involuntary treatment of patients who neglect their essential needs have contributed to this trend. The impact of these visits on hospital based psychiatric emergency rooms is discussed in terms of increased clinical and legal responsibility for the disposition of persons who are considered dangerous including those who are self-neglectful of their own essential needs.

TRAINING IN COMMUNITY PSYCHIATRY: NEW OPPORTUNITIES

The authors describe the impact on training that accompanied an assignment of senior (PGY-4) residents to work one-half day each week for a six month period at a community-based agency concerned with the care of persons with severe and persistent mental illness who were formerly homeless. As the goals and methods of psychiatric training are rethought and adapt to programmatic shifts and economic pressures, new opportunities open up to move treatment and training to the “front lines” in the community where an innovative therapeutic armamentarium for persons with severe and chronic mental illness is developing.