The young adult chronic patient: population overview

Uninstitutionalized young adults with chronic mental disorders and social disabilities pose a new challenge in community psychiatry. These attention-seeking, help-rejecting young men and women spend most of their lives in the community and differ markedly from older deinstitutionalized chronic psychiatric patients. Many confound identification by their abuse of drugs and/or alcohol. Most deny their mental illness and make inappropriate use of mental health services available to them. Because of the different problems and aspirations of these patients compared to older chronic patients, treatment programs must be age segregated to address these differences. Young adult chronic patients are best helped via flexible, accessible, nonstigmatizing, team-oriented treatment programs. Some patients require long-term neuroleptic therapy at low maintenance doses. In addition to their role as the primary provider of psychiatric care to these patients, psychiatrists must act as advisors to families and community planners and as political activists to focus additional attention on community-based (rather than state hospital-oriented) programs.