Rather than having three levels of treatment (routine periodic treatment in one’s doctor’s or therapist’s office, attendance at a day treatment or partial hospitalization program, and inpatient psychiatric wards), I propose that several more such levels be created. Among them:

1. A level of outpatient clinical care, similar to partial hospitals, but perhaps a couple of hours a day, one or more days a week;
2. Another level of outpatient clinical care, this one being only one or two hours a day, every day, early in the morning or in the evening so that patients can work;
3. Visiting-nurse or in-home counseling care, in which a qualified psychiatric nurse checks in on the patient in his or her home, either daily, or a few days a week;
4. And for those times when inpatient care is unavoidable, wards devoted to mood-disorder patients are in order. These are places where their particular needs are addressed, and which have a population of similar patients for them to relate to, along with outdoor activities (where practicable), since exercise is important to recovery.

This will have the added benefit of allowing attending physicians and other staff, to treat mood disorder patients as they need to be treated, without being distracted by the varying demands of a much larger population.

There are other possibilities. Oddly enough, some of them are being tried, in various places, but they aren’t always accepted by the rest of the system. In fact, many renowned facilities are now doing some or all of these things. Why aren’t the rest? What are they waiting for?

That must change. But will it?

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