Rehab Rounds: Improving Pharmacotherapy in a Psychiatric Hospital

Introduction by the column editors: Rehabilitation of persons with severe mental disorders is of necessity a biobehavioral endeavor, with control and stabilization of symptoms the foundation for helping individuals achieve their personal goals through building skills and providing social support. Several recent studies have documented the importance of minimizing symptoms and maximizing cognitive functioning to ready individuals for rehabilitation services (1,2). Because of the key role of pharmacotherapy in the management, reduction, or removal of symptoms as obstacles to the attainment of the individual's rehabilitation goals, it is essential that drug interventions be of high quality. However, recent studies of drug-prescribing practices for severely mentally ill patients have documented the inadequacies of this essential first stage of rehabilitation (3,4).In this month's column, Robert E. Moebius, M.D., and colleagues who worked with him at Camarillo State Hospital describe several quality improvement programs that were instituted at the facility to raise the quality of pharmacotherapy provided by the staff psychiatrists and physicians. Also highlighted are the clinical benefits that can result from the formation of an alliance between a public mental health institution and an academic medical center. The success of this public-academic liaison led to the hospital's receiving an award from the American Psychiatric Association in 1991 for excellence in state-academic collaboration.