High and Intensive Care in Psychiatry: A New Model for Acute Inpatient Care

Psychiatr Serv. 2021 Apr 1;72(4):475-477. doi: 10.1176/appi.ps.201800440. Epub 2021 Jan 12.


In response to three reforms in Dutch mental health care, an organizational framework, including methods and interventions, was developed as part of a new model for acute inpatient care. Core elements of high and intensive care (HIC) include preventing seclusion by means of a stepped-care principle; a six-step process of admission, treatment, and care; combining medical and recovery approaches; combining professional and experiential knowledge; and providing a healing environment. The HIC model differs from the utilization of psychiatric intensive care units in that it focuses on collaboration with outpatient care; establishing contact between staff, patients, and relatives; and minimizing coercion.

Keywords: Crisis intervention; Models/theories of psychiatry; reduction of coercion.

MeSH terms

  • Coercion
  • Critical Care
  • Humans
  • Inpatients
  • Mental Disorders* / therapy
  • Psychiatry*