[Characteristics of psychiatric day care units: a tentative clarification]

For more than 20 years now, an important literature has informed us of the advantages and disadvantages of Day Units, but sometimes in a way which is not always impartial. In the same view the delimitation of the aspects of Day Units and the appreciation of their great field of application are sometimes not all that clear. These component units associated with the conservative outlook of health politic planners and the majority of psychiatrists are promoting factors for the use of psychiatric hospitalizations instead of the use of Day Units and Out-patient facilities on the whole. In this paper, we will start by outlining the frame of the "Day Unit", in its specificity in regard to full time hospitalizations and other modes of psychiatric assistance. We would like to point out the extreme diversity of Day Units according to the type of patients treated, the age, the aims of the institution, the connections with other psychiatric units, the modality of admission etc. Following this, we will try to show what the intrinsic characteristics of Day Units are, especially in comparing them to those of full time hospitalizations; treatment during the day, reduced costs, greater feeling of the outside world, greater automony of the patient, less accent on the fear of madness, less humiliation, reduced fear of psychiatric institutions. Using these intrinsic characteristics, we have tried to define the potential characteristics which are derived directly from the above, but which, to be fully developed, implicate a therapeutic option: better quality of team work, facility for the use of non-directive psychotherapies, prevalence of psycho-medical treatments and sociotherapeutic treatments over the administrative and bureaucratic orders. Finally, we point out that many characteristics of the Day Units, often called intrinsic or potential, issue from conjunctural factors such as the small size of the unit, the convenient geographical situation, the facility for utilization of new therapeutic technics etc. The development of the Day Unit movement was able to profit from the ongoing critic of the usual psychiatric hospital practices and experiences. We do hope that this paper will help to make clear the frame, the different way of application and particularly the characteristics of Day Units which deserve to be well known, well utilized, so that the different psychatric facilities will be able to profit from their use and through this, all those for whom we are asked to care for.