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Intensive Home Treatment for Acute Mental Disorders: An Alternative to Hospitalization 1513 In 1978, I became the medical director of a general hospital psychiatric unit serving the twin cities of Kitchener/Waterloo in southwestern Ontario, Canada. Over the next four years, population growth accelerated, and more psychiatrists joined the department, both of which resulted in increasing pressure on beds. We reached a point where patients had to wait a dangerously long time to be admitted. The provincial Ministry of Health policy was clear: no more funding for hospital beds only funding for community programs. I couldn’t see a way forward. An acute day hospital did not seem feasible; most of our patients were too ill to reliably attend, and public transportation is poor. There were no workable models for a crisis residence at that time.

United kingdomBritish columbiaUnited statesNew zealandMendota mental health instituteHazel glenNew south walesUniversity collegeFred fentonNeil brimblecombeSashi sashidharanLeonard steinUniversity college londonAssertive community treatmentMinistry of healthMental health nursing