Ultrashort Stays and a Focus on Recovery—In Reply

We agree completely with Dr. Barber's contention that even ultrashort hospitalizations can become more recovery oriented than they currently are. Implementing recovery practices on inpatient units requires an attitude of culture change in which the focus shifts from getting the work done in the most efficient manner to ensuring that patients' interests are at the center of all we do. The problem with ultrashort hospitalization as it is practiced today is embedded in this notion: the patient's best interests, especially as the patient and the recovery community may see them, are often at odds with an institutional staff that is obligated to move the patient through a mindless sequence of steps in a very limited time frame. Recovery-oriented inpatient treatment requires respect, dignity, and careful attention to the context of the patient's life. Let's be respectful and spend the time necessary to do this right.

We appreciate Dr. Masters' thoughtful approach to the admission and treatment of children and adolescents. When the sole focus of a hospital stay is crisis stabilization and safety, this precludes such an attentive approach to the special needs of children.