Short-term hospitalization for suicidal patients within a crisis intervention service

This article describes management of two cases in a short-term medical/surgical setting developed by a crisis intervention service in a general community hospital. These patients have common links of suicidal threats, ambivalence about psychiatric hospitalization, and noncompliant character structures that lead to a manipulation of the mental health system. Cases selected are representative of a subset of patients who historically don't do well on a regular inpatient unit. We will examine the clinical change during short-term hospitalization, explore psychodynamic issues, and describe the integration within the overall mission of an acute care general hospital. The cost-saving implication for brief hospitalization in a medical/surgical setting for maintaining chronic mental patients in the community is also discussed.