2011 issue 2

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Volume 20, issue 2

Case report

Between the Scylla of hospitalization and Charybdis of untreated psychosis – dilemmas of the patient and his psychiatrist. A case report

Janusz Chojnowski1
1. Oddział Psychiatryczny, Szpital Ogólny im. Witolda Ginela, Grajewo
Postępy Psychiatrii i Neurologii 2011, 20(2): 141–148
Keywords: schizophrenia, therapeutic alliance, Mental Health Act

Abstract

Objective. The paper presents the dilemmas faced and decisions made by the psychiatrist in his clinical practice.
Case report. A female patient treated for schizophrenia prior to her hospitalization had asked her doctor to disregard her request for discharge from the hospital should such a request be made during her hospital stay. She subsequently did request discharge during her hospitalization and was involuntarily detained on the grounds of the Mental Health Act. This allowed to achieve a beneficial treatment outcome and to form a therapeutic alliance with the patient.
Commentary. From the legal viewpoint these are banal phenomena, but from that of the patient-psychiatrist relationship they are of pivotal importance, being most significant for the therapeutic alliance. In the author's opinion the matter is deserves reflection.