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The different types of inpatient psychiatric services provided by a facility depend upon its primary designation as an acute care provider or a long-term, or residential care, provider. In the US, most residential or long-term care providers for chronic psychiatric patients are state-run facilities that began to be markedly reduced in the 1960s in favor of outpatient clinics combined with semi-independent living. This well-intentioned but poorly planned and implemented policy resulted in mass discharges of patients ill-equipped to live independently and without access to sufficient numbers of outpatient care providers and counselors. The other type of facility that provides inpatient psychiatric services is acute care psychiatric hospitals. These institutions are not residential; instead, they provide treatment for newly diagnosed psychiatric patients, those in crisis, or those experiencing an acute exacerbation of their disease.
A significant aspect of inpatient psychiatric services is that of safety. Many psychiatric disorders put their sufferers at risk for self-harm or suicide, especially those patients diagnosed with depression, bipolar disorders, schizophrenia or medication noncompliance. Patients at risk of harming themselves or others are held in a secure environment where their opportunity to harm themselves is minimized by architectural modifications and other risk-reduction measures. There are usually graduated levels of unsupervised activity allowed, based upon a physician's evaluation of the patient's mental state. A patient's affect, compliance with the treatment plan, and level or orientation are also taken into account when determining the degree of supervision needed while receiving inpatient psychiatric services.
After safety, most inpatient psychiatric services are geared toward medication management treatment, or psychopharmacology. Different medications, different combinations of medications, or differing doses of medications are used to stabilize the patient and control symptoms of their diseases. Careful evaluation and assessment is necessary to ensure that patient symptoms are adequately treated with the lowest possible dose of medication, in order to decrease the occurrence of side effects. Some psychiatric medications have unpleasant or undesirable side effects and these often influence patients' compliance with their prescribed medication regimens.
Inpatient psychiatric services also include individual and group therapy sessions, depending upon a patient's ability to participate. Topics for group sessions often include coping skills, stress and relaxation techniques and communication, which are all difficult areas for many patients suffering from a psychiatric disorder. Any type of non-pharmacological therapy necessarily depends upon a patient's diagnosis. For instance, patients with serious depression might undergo electroconvulsive therapy (ECT) for depression that fails to respond to medication, while patients with eating disorders might experience supervised meals, calorie counts and daily weigh-ins. Due to the enormous expense of inpatient psychiatric services and care, patients are often discharged for continued outpatient care as soon as safely possible.
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