The Psychiatric quarterly
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The Psychiatric quarterly · Jan 1995
From conversion to coercion: the police role in medication compliance.
This paper examines the role of the police in supporting community based mental health services for the chronically mentally ill in a mid-sized midwestern city. Cooperation between the police and mental health system, as reflected in training and procedural agreements for emergency evaluations and hospitalization, achieves the conversion of the police to a medical model view of mental illness which stresses the importance and effectiveness of medication compliance so that the police will act upon this belief in their handling of the mentally ill. ⋯ Erosion of the police belief in the effectiveness of community mental health, and the resulting change in practices, may provide an important, yet partial, counterbalance to the control exerted by the medical model. The availability of police authority to assure compliance, or in some cases to reinforce the consequences of non-compliance with medication, raises questions about police-mental health relationships that are too cooperative.
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The Psychiatric quarterly · Jan 1995
Clinical and administrative consequences of a reduced census on a psychiatric intensive care unit.
The Psychiatric Intensive Care Unit at the FDR VA Hospital is a specialized ward designed to assess and treat suicidal and assaultive patients. Since its creation in 1983, over 1600 admissions have taken place. The authors have previously reported that patients referred for aggressive behavior had a statistically significant higher recidivism rate, as well as a statistically significant longer length of stay. ⋯ When the census cap was decreased, the referral pattern changed and the patients were even more likely to be aggressive. Length of stay decreased dramatically leading to a unit with a significantly higher turnover rate. Clinical and administrative concerns are also discussed.