When is hospitalization necessary?
Most of therapy takes place outside the hospital, usually during the patient's stay at home with the family. However, sometimes hospitalization is necessary. Psychiatric hospitalization for people with schizophrenia becomes advisable when there was an episode of acute illness and:
- the patient is unable to control their behaviour to the point that there is a well-founded fear the patient may pose a threat to their safety or that of others (serious risk to human health and life);
- the patient denies that their condition has deteriorated, refuses to take medications, and it may be reasonably assumed that the patient's current condition will further deteriorate;
- due to the condition deterioration, the patient ceased to satisfy their basic needs, i.e. the patient sleeps outdoors, does not eat or drink;
- the schizophrenic patient suffers also from a serious physical disease, or such side effects of medications occur that it will be impossible to cope with them without the person's stay in hospital.
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At the same time, usually during the first episode, psychiatric hospitalization, which will enable accurate diagnosis of the illness and allow for planning of further therapy, is indicated even if there are no factors for hospitalization given above.
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If, however, the patient does not need hospitalisation and the results of therapy at home are satisfying, the patient may be proposed several, so-called, indirect forms of therapy (a more detailed information on this issue may be found in the Article "Indirect forms of psychiatric care", in the category "Health care units").
- stay on a day care ward – for example, from 8 a.m. to 3 p.m., for five days a week, usually combined with an intensive occupational therapy;
- therapy at domestic treatment ward – where from time to time a physician, psychologist, or nurse appear at the patient's home and the patient's family fulfils on a daily basis the role of a therapeutic guardian of the patient;
- stay at a hostel – a house or apartment for patients, usually young people, in which they learn collaboration and independent living – therapists come to the hostel just to monitor therapy;
- therapy at home environment instead hospital.