ABSTRACT

When one asks MCHT clinicians which patients are difficult to treat in their service, manic patients are often mentioned. However, some report success, and our experience is that MCHT treatment can divert some of these patients from the hospital and shorten the length of admission for many others. Indeed, treatment in the home may have certain advantages for manic patients, whose behavior presents specific challenges to an in-patient milieu. Manic patients are often irritable, self-centered, grandiose, and demanding-characteristics that can quickly bring them into conflict with the rules and restrictions that are part of life on an in-patient ward. Busy nurses are not able to give these patients the leeway and control they need. Their overactivity, irritability, increased social and sexual drive, and lack of empathy for others causes concern for how they will affect other patients, many of whom are very vulnerable.