OBSTACLES TO THE CARE OF PATIENTS WITH MEDICAL-PSYCHIATRIC ILLNESS ON GENERAL-HOSPITAL PSYCHIATRY UNITS

Although patients with both physical and mental illness (combined illness) are common in general hospitals, psychiatric units have been traditionally reluctant to accept such patients for intensive psychiatric care. This article presents three case reports of patients with combined illness who were largely refused at psychiatric units despite stable vital signs, and discusses factors compelling and hindering psychiatric unit acceptance of such patients. Such patients can be managed on psychiatric units when hindering factors are addressed. The most critical factor is an ongoing collegial relationship with nonpsychiatrist consultant physicians and nurses. The psychiatric unit can improve its worth and reduce stigma and mystique within the general medical hospital by becoming more accepting of these patients.