Study on an Innovation in Military Psychiatry: Application of the Concepts of Combat Psychiatry to the Fort Hood Psychiatric Day Hospital,
LETTERMAN ARMY MEDICAL CENTER SAN FRANCISCO CALIF
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A psychiatric day hospital was opened with a goal of optimizing the treatment of soldiers by applying the principles of combat psychiatry. This is the first time a psychiatric day hospital has been operational at Fort Hood. The operation of one psychiatric day hospital in military settings was informally identified by the authors. The task was to take existing treatment technology in the partial hospitalization field and implement it in form and function consistent with both optimal patient care and Army mission objectives. As background information this paper reviews the effectiveness of psychiatric day hospitals in civilian settings. The application of the principles of combat psychiatry was intended to optimize solders psychiatric treatment by reducing their length of hospitalization and keep them more closely associated with their units. This is important since these principles represent the lessons-learned in psychiatry, psychology, and social work from previous wars. However, there is confusion in the combat psychiatry literature and in Army doctrine about what these basic principles are. Thus, this paper also reviews the traditional basic principles of combat psychiatry and presents our revisions by identifying the organizational and treatment implications of the principles. The revised principles were then applied to our day hospital and can serve as a foundation for further developments.