Optimizing Pharmacotherapy of Schizophrenia: Tools for the Psychiatrist

The pharmacologic treatment of schizophrenia presents several challenges: 1) available treatments are incompletely and variably effective; 2) treatments take time to show their full effects; and 3) different benefits and adverse effects of treatment appear over different time frames. To aid in treatment decisions, clinicians are inundated with information that can be difficult to digest and integrate. Treatment often is provided within systems of care that limit the range of available treatment options. To preserve broad treatment options and facilitate optimal care, the State of Florida has developed a comprehensive program to provide several tools to the treating physician, and systems of care to promote optimally effective and efficient pharmacotherapy for each individual with schizophrenia. Although a formal evaluation of its effectiveness is underway, the program has been uniformly well received and considered to be very useful in helping clinicians and treatment systems efficiently provide schizophrenia patients with the best currently available pharmacologic treatment. Elements of the program and its evolution and operation are described

Redesigning Emergency Room Psychiatry in New York

Significant changes in the characteristics of persons using psychiatric emergency services have resulted in increased demands beyond the needs emergency services traditionally have been expected to meet. In New York City, these changes caused a crisis in psychiatric emergency services. The authors report a state statute that gave the New York State Office of Mental Health the authority to license a specialized psychiatric emergency service, a comprehensive psychiatric emergency program, within general hospitals designed to provide specialized assessment, stabilization, and referral services