Treatment Orientation and Program Implications

Abstract

The advent of the first day hospital treatment program in North America at the Allen Memorial Hospital in Montreal (Cameron, 1947) marked the beginning of a new era in the treatment of psychiatric patients and in the way psychiatric illness is viewed. Prior to this innovation, the majority of psychiatric patients were treated on inpatient units at private and general hospitals or in state facilities that were usually placed in isolated areas away from the general population. When socially abhorrent symptoms were reduced (e.g., suicidal ideation, hallucinations, delusions) the patient was returned to his family and the community, where he was then treated on an outpatient basis, usually no more than once per week. Partial hospitalization programs or day hospitals proposed that patients be treated on a partial or day basis, eliminating the need for 24-hour care and keeping the patient in the community. Several years following the opening of Cameron’s unit, day hospitals began to spring up in other areas of North America including the United States. Eventually evening programs were also made available for those individuals who were functioning well enough to participate in various activities (E.G., vocational Training programs, attending school, working, actively job seeking, household responsibilities) but who were nevertheless in need of more intense treatment than is usually provided in outpatient theraphy.