Article: Patient dynamics, staff burnout, and consultation-liaison psychiatry.

Many factors contribute to hospital staff burnout. One recent development is the increasing severity of illness and consequent high intensity of services required to treat patients under the prospective payment system. Aggressive case management diverts from hospital admission any but the sickest patients. Associated with increasing severity of illness is an emotionally disturbed patient population for whom acute psychiatric admission is inappropriate. This includes large numbers of chemically dependent individuals with severe personality disorders. Such individuals, frequently exhibiting disruptive behavior, [1] place a strain on staff-patient relations that often ...

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