An inpatient admission to a psychiatry ward has a high cost both eco–nomically and psychologically. While it is necessary at times to treat someone in hospital, the majority of the work in maintaining good men–tal health is done while the patient is living their usual life with its highs, lows, and challenges. Community psychiatry aims to manage people with mental illness in their own environment. There are many benefits to this, including promoting a sense of normality, allowing for continued support from family and friends, and helping to bridge the change between ill–ness and recovery. Because of this, community psychiatry covers almost everything in psychiatry and is as much a speciality of exclusion as a spe–cific group: no under 18s (child and adolescent), over 65s (psychiatry of old age), addictions (substance misuse), or the law (forensic psychiatry). But a community psychiatrist can’t be too exclusive because local differ–ences, based on what other dedicated services are available, and sub–threshold presentations mean that a good working knowledge of most conditions is essential. In many ways, community psychiatrists are the GPs of the speciality. The only way to manage such a large and varied workload is to make good use of the multidisciplinary team (MDT): community psychiatric nurses (CPNs), occupational therapists (OTs), speech and language therapists (SALTs)—the list of acronyms is endless but essential. A good community psychiatrist has a team they can rely on to help keep a watch–ful eye over their clinical population; managing their day-to-day care and anticipating problems before a relapse develops. The balance between giving space for recovery and monitoring to ensure efficient treatment is hard to achieve but gratifying when it occurs. Part of the skill set of a good community psychiatrist is an understand–ing of the research statistics: prevalence of disorders, treatment rates, and prognosis. These allow for faster diagnosis and evidence-based treatments to speed up recuperation. The minutiae of these facts aren’t needed, but a broad understanding helps shape assessment and management.
Keywords: Caldicott Guardians, agranulocytosis, behavioural family therapy, blood glucose tests, change cycle, citalopram, delusional disorder, early intervention services, gedankenlautwerden, hypercalcaemia, methylphenidate, neural tube defects, obstetric complications, social difficulties in childhood, tetralogy of Fallot
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