Acute and chronic psychiatric care: establishing boundaries

Area of Science:

• Psychiatry and Mental Health Services Research

Background:

• Despite psychiatric advances, severe mental illness episodes and partial recovery remain challenges.
• Existing mental health systems face complexities due to a legacy of public and private tiers.
• Evolving health care financing and delivery necessitate clear definitions of care levels.

Purpose of the Study:

• To define and provide examples of acute and chronic mental illness and care.
• To explore challenges in classifying mental health care levels.
• To consider principles and plans for financing and delivering care for the chronically mentally ill.

Main Methods:

• Conceptual analysis and definition of acute vs. chronic mental illness and care.
• Review of existing financing and care delivery models for chronic mental illness.
• Discussion of principles for integrated public and private mental health systems.

Main Results:

• Proposes clear definitions for acute and chronic mental illness and associated care.
• Identifies inherent problems in classifying mental health care levels.
• Reviews two innovative chronic care plans as illustrations.

Conclusions:

• Integrated public and private mental health care systems are essential for acutely and chronically ill patients.
• Health reform presents an opportunity to improve mental health care delivery and financing.
• Consensual definitions of care levels are crucial for effective system reform.