It is a source of shame for our nation that for most Americans in need—especially those with serious mental illness—the mental health system is dysfunctional. Provision of population mental health services is a complex systems issue that requires multiple stakeholders to work in partnership to improve it. Federal and state governments (as funders of both care and research), clinicians, hospitals, accountable care organizations, and insurers, as well as patients and families, are key stakeholders. Only the federal government has authority to convene all of the former, but Washington’s current dysfunction makes this unlikely. Nevertheless, we can fix some of the ways the system is broken. I will focus here on 2 critical areas—the paradigm of clinical care and implementation of parity.
Many patients lack the capacity to manage intense affects between therapy sessions, and as a result are caught in impasses as treatment becomes organized around fending off the next crisis or recovering from the last. Risk of suicide is often part of this presentation. Among the range of interventions that may help such patients emerge from impasse and treatment resistance is residential treatment, particularly psychodynamic residential treatment. We describe the role of residential treatment for such patients and offer an illustrative case example.
In the introduction to a special section of Psychoanalytic Psychology, Dr. Christina Biedermann (2014) outlines the purpose of a recent conference focused on war trauma and its treatments. The goals of the conference were to learn more about the experiences of soldiers and veterans; regain a relationship with them; and consider what they might need of clinicians, researchers, policymakers, and citizens.
The Textbook of Hospital Psychiatry, written by 70 national experts and clinical specialists, covers a wide range of clinical and administrative topics central to today’s practice of hospital psychiatry.
In 1992, the Austen Riggs Center began to a multi-dimensional research study which followed 226 newly admitted patients. The study investigated many basic questions, including: Do chronically suicidal patients fully recover, and if so, how?