Ambulatory treatment of the psychotic crisis

Abstract

Current efforts to improve the community-based care of psychiatric patients often include attempts to encourage the ambulatory treatment of acute psychosis by non-psychiatrists. New therapies and revisions of older methods now allow this to be done with many patients for whom, 15 years ago, state hospitalization would have been the first step in treatment, and often the last. Many techniques applicable to the ambulatory treatment of acute psychotic crises can be used effectively by non-psychiatrists. This review describes ambulatory treatment programs for the more commonly encountered acute psychoses. It emphasizes methods which have only recently become available and those which can be used effectively and safely by the non-specialist. With the skillfully combined use of pharmacotherapy, environmental modification, office psychotherapy, legal aids and community resources, the interested nonpsychiatrist can undertake the ambulatory treatment of many psychotic crises.