[6 years of psychiatry in a general hospital]

Six years of experience in the psychiatric and neurologic department of the General Hospital at Itzehoe (122 beds, including 78 psychiatric patients and 44 neurological patients; 5 assistant physicians, 1 psychologist, 2 senior physicians, 1 Medical Director [Head]; 38 nurses, 1 social worker, 2 occupational therapists) allow us to summarize initially the efficiency of such an institution: A department like this is basically able to take over full responsibility for the psychiatric care of a community district including the town and adjacent areas of other districts (totalling 120,000 inhabitants). The prerequisites--as is the case in the Steinburg district--are that a hospital is available for patients with chronic mental diseases; close cooperation with an established sociopsychiatric service; and, last but not least, a possibility of transferring patients for the purpose of long-term rehabilitation and withdrawal treatment in relevant institutions. Hence, it is absolutely out of place to label such work performed by "small" departments as "gilded" or "miniature psychiatry". Such departments are increasingly becoming the representatives of a type of psychiatry which definitely has a future because it operates near the patients' domiciles. However, it will be necessary to revise the job schedules, since the number of personnel employed in this type of work is by no means sufficient for conducting a type of psychiatry which is in line with modern concepts and requirements.