The psychiatrist should be called in as soon as the patient is admitted to the general hospital. Indeed, he may often have seen the patient already and arranged the admission. During the period of physical treatment he will be establishing a relationship with the patient, which will continue after the need for treatment in the general ward is over and the primary responsibility for the patient’s care passes to him.
The patient will be transferred to a psychiatric unit, which may be a ward in the general hospital, or a psychiatric hospital, or may be a specialized unit for alcoholism situated in either.
There are 4,000 alcoholics admitted annually to psychiatric hospitals in Britain. They go into over 150 such hospitals. Unfortunately, most of these hospitals have no special programme in operation for treating alcoholics. Only in a handful are there psychiatrists who are especially interested and experienced. Unless a treatment programme is provided for them alcoholic patients may receive little attention during their stay in hospital and their willingness to persist in treatment will accordingly be lost. Under such conditions they will almost certainly not be prevented from drinking again when they are discharged. Many alcoholics recount the dismal charade that goes on of bottles of whisky being smuggled into the hospital for covert consumption by despairing patients. The time passed by the alcoholic in such hospitals may allow him to recoup his physical strength but otherwise it is waste-fully spent. When the patient is discharged he and his doctor may part company, sometimes with mutual relief; neither feels he has succeeded. The lack of planned treatment in hospital is frequently matched by a failure to provide adequate outpatient care after discharge. This unsatisfactory state of affairs does not prevail in every psychiatric hospital. Some are outstandingly active in their treatment programmes for alcoholics.