One (or more) flew out of the cuckoo's nest | |
Acute inpatient psychiatric care. A source book.Treatment Protocol Project. Sydney: WHO Collaborating Centre for Mental Health and Substance Abuse 1999 (xiii + 353pp.). ISBN: 0 9587052 7 5. |
Australia, like many other countries,
most notably the United States of America and the United Kingdom, has gone some way towards the devolution of large psychiatric hospitals, and shifted resources into community-based care. Concurrently, psychiatric hospitals have been down-sized and replaced by smaller units, often located at general hospitals. These shifts have inevitably had a major impact on the way psychiatric inpatient services are run. Long term care can no longer be provided and services are under continual pressure to return patients to the community. This volume, from the Treatment Protocol Project, is a welcome attempt to define the new role for inpatient psychiatric facilities, to define their place in the complex matrix of psychiatric service delivery, and to provide some very practical advice about running such facilities safely and efficiently. The scope of the book is broad but neither too wordy nor contradictory. There are some sections which seem a little prescriptive and perhaps not universally relevant or applicable, but the underlying principles are sound and always pragmatic. It is a well-presented book, with good indexing, succinct chapter summaries, and a division into sections and appendices which make it easy to use as a reference book. Having said this, the section on "Problem presentations" could have been spaced better, with each new topic starting on a fresh page. The appendix on "Educational resources" is a good example of the way in which this layout works to make the book not only more visually pleasing, but also more readily negotiated. Overall, however, it achieves its aim and it is a pleasure to read a book which actually makes sense to the clinician as well as the clinician-manager. David J Castle
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