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Abstract
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The author's work with families presenting to a psychiatric emergency service points to the prominence of families' wishes that one family member be hospitalized. The pressure on the cliniciancan be extreme. A number of studies in the literature on the decision to admit contain similar observations emerging from varied methodologies and vantages. The author draws from clinical practiceand the literature to focus on an interpersonal dimension to emergency interventions. Awareness ofinterpersonal forces upon mental health clinicians is crucial to allow mature balancing of the many factors involved in the decision making process. An integration of family and systems thinking into the practice of emergency psychiatry can enhance comfort and effectiveness in many difficult crisis situations. VioLit summary:
OBJECTIVE:
The purpose of this paper by Perlmutter was to examine the prominence of the influence of the family on the decision to admit a fellow family member to a Psychiatric Emergency Service (PES).
METHODOLOGY:
A non-experimental exploratory design was employed using a focused literature review and clinical observation. Variables affecting decisions to admit were reviewed including the role families play.
FINDINGS/DISCUSSION:
A repeated observation in the literature was that the decision to admit is significantly influenced by a request by the patient's family or social network. Some individuals or families, it was argued, can become addicted to hospitalization as immediate relief and help for the affected person. It was also found that hospitalization may be related to the fact that an interviewer cannot or does not say no when a family strongly requests hospitalization. AUTHOR'S RECOMMENDATIONS:
For further study, the author argued that emphasis needs to be placed on the pressure that can be exerted upon clinicians by people involved with the identified patients. The author stated that it is necessary that decision makers be aware of systematic factors that direct their action. Psychotherapeutic skills and the ability to adapt a problem solving approach were suggested to be in the repertoire of all emergency clinicians. EVALUATION:
This study looks at the interesting issue of the use of emergency psychiatry among families in crisis. However, in order to have substantial value, this study should be replicated with more systematic scientific study. The data from this study are not amenable to generalizability because of their source being from one specific place and from the practice of one specific practitioner. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)
KW - Mental Illness
KW - Mentally Ill Juvenile
KW - Family Relations
KW - Mental Health Intervention
KW - Psychological Factors
KW - Mental Health Institution
KW - Adult Violence
KW - Adult Suicide
KW - Suicide Intervention
KW - Violence Intervention
KW - Mentally Ill Adult
KW - Juvenile Violence
KW - Juvenile Suicide
Language: en |