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Psychiatric hospitals and psychiatric departments in a general hospital

Psychiatric hospitals and psychiatric departments in general hospitals are for the most part "differentiated according to specific sectors", i.e. they are basically obliged to provide care for all persons in a clearly defined region. For a long time, hospital treatment was considered to be equivalent to bed care. However, there are now day-care centres to be found almost everywhere and ever more ambulatory offers for treatment are also available, the so-called institutional out-patient departments.
Previously, one believed that seriously ill patients should be cared for in hospitals and that those with mild illnesses could be cared for as ambulatory patients. Meanwhile, one can sometimes get the impression that the contrary is the case. At any rate, there are some very stubborn patients who never undergo stationary treatment and also those who have been afflicted with psychoses for a longer period of time and have spent most of their time outside of clinics.

Some clinics have specialized, and others have mixed stations and ambulatory care centres. Both have their advantages and disadvantages. Finally, specialisation accounts for the special patient and family in their direct social environment. 

The so-called "closed ward" has long become an obsolete model in many places; after all, collecting too much uneasiness at one site does nobody any good. It has proven to be better if the different, responsible wards close their doors regionally - and then, only as this proves to be absolutely necessary. The more that the wards learn to "tone down" atmospherically and to provide relaxation, the less frequently does the need for this prove to be required.

Clinics have the advantage in that they can offer a multiprofessional team: Doctors, nursing services, social education workers, psychologists/psychotherapists, occupational therapists and other groups of employees, which should serve to suit a very different proportion of both healthy and sick patients. The greatest challenge in the future will consequently be to manufacture an overlapping continuity, so that as much as possible of the same therapy should be responsible for the ambulatory and (partial) stationary treatment, so that much more trust can develop and the otherwise frequently observed interruptions in relationships can be avoided.

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