Anxiety Depression Treatment

Day hospitals


Day hospitals are valuable in two ways in the treatment of acute psychiatric disorder: they can avoid admission to hospital for some patients; and they can shorten in-patient stay by taking over the care of patients when they no longer need the full facilities of an in-patient unit. For acutely ill psychiatric patients, day care is most appropriate for those who can be with their families in the evening and at weekends.

Suitable conditions include depressive disorders of moderate intensity and without substantial risk of suicide, anxiety and obsessive disorders, and some eating disorders. Day care should be planned as carefully as in-patient care, with an active treatment program specific to each patient's needs. Although the general supportive function of the day hospital has some value, if there is no active program patients may become dependent and discharge may be delayed.

Diversion to day-hospital care has been compared with admission to hospital for patients with acute psychiatric illness. The results indicate that between a third and a half of admissions can be diverted successfully without worsening the clinical or social outcome and with a reduction of the burden on relatives. There are insufficient data to be certain that diversion is as safe as admission, though no evidence that it is not. Direct costs are reduced by between about 20 and 35 %. To date the approach has not been widely adopted.

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