Involuntary Admissions to General Hospitals: Progress or Threat?

For a variety of reasons, general hospitals are being asked to accept both involuntary admissions and patients who are difficult to manage safely on an unlocked unit. The author considers some of the programmatic, legal, architectural, and economic issues that must be resolved if this challenge is to be met successfully. He also addresses the public relations issues and the impact on psychiatry's liaison to general medicine. He believes that if psychiatric services in general hospitals are broadened thoughtfully and deliberately, with careful attention to the clinical needs of all patients, the over-all quality of psychiatric care can be enhanced. Otherwise there is risk of destroying the best of modern hospital psychiatry.