PSYCHIATRIC NIGHT TREATMENT UNIT IN A GENERAL HOSPITAL
A. E. MOLL M. D.1
1 Montreal General Hospital, Montreal, Canada.
The advantages of a night centre may be briefly summarized as follows: (1) the main function is to enable individuals to undergo psychiatric treatment without interruption of their working hours; (2) it facilitates the acceptance of psychiatric treatment by those individuals who, for reasons other than financial, would refuse treatment if this involves hospitalization. Not infrequently the fear of insanity is such that hospitalization is interpreted by the patient as confirmatory evidence of their unwarranted belief of being "insane"; (3) it enables individuals to accept psychiatric treatment without disclosing this need to anyone apart from the immediate members of the family. This is especially important to the employee who fears the loss of his job or jeopardy of promotions, should his employer know that he is "a psychiatric case"; (4) it is economical to both the patient and the hospital; (5) treatment at the night centre does not interfere with the patient's social activities, particularly since he has the weekends to himself. This, together with the fact that he is employed during the day, tends to minimize the regressive phenomena contingent to hospitalization and overdependence upon the hospital; (6) it facilitates the weaning process of patients previously hospitalized in the inpatient section or in the day centre, by giving the patient some support during the early stages of his re-adjustment to work; (7) it makes it possible for individuals to undergo psychiatric treatment during the only time they can be spared from their daily activities, e. g., the mother who can undergo treatment only after the husband has come home to take care of the children; (8) it offers facilities to individuals who can be helped by weekly psychotherapeutic interviews after working hours; (9) it provides an over-night service for the emergency psychiatric night cases who appear in the casualty department of the hospital.
I trust that the enumeration of these several advantages does not lead one to the assumption that a night treatment unit is the answer to the immense problem of the treatment of mental illness. It is purely a small extension of the psychiatric service which any large general hospital should be able to provide. It is, however, a new venture, and I trust a seed which, in time, may sprout and lead to the establishment of night treatment facilities in other hospitals and possibly also in specialties other than psychiatry.
