Psychiatry & Psychology

The Psychiatry Department operates on the principles and modalities of institutional Psychotherapy i.e. any person who works in the team has a therapeutic function. In the words of Michael Balint, “The most prescribed drug in the world is the doctor himself,” All the team members, whatever their function and technique “prescribe” themselves to the patient in the department. The result is a friendly atmosphere which helps the patients in the healing process as much as the drug therapies. Patients cease to feel excluded, foreign to others and to themselves. The effect of segregation related to psychiatry disappears. Our service has become a “home” for hospitalized patients and for those who have left the service. Witness the “visits” made by patients to the department once they have left. Some patients come to stay there in the living room, doing nothing, alone or with others …

This has helped the patient to win back his place in his family where he was first excluded. Exclusion stems from the strangeness of the symptoms. Faced with this strangeness and the anxiety it arouses, the family eventually identifies the patient by a “he” that opposes the “we” she refers to herself, creating a divide that isolates the patient within the family. The fact that the symptom is understood by the caregivers and dealt with with respect, the patient will no longer feel left out. This home offered by the team will greatly facilitate the patient’s prescribed treatment. Psychopharmacological treatments, psychotherapeutic interviews, psychotherapy group, talk groups and appraisal interviews are experienced by the patient without any intrusive note. The same applies for regular meetings with the patient’s family and in his presence. All these treatments help the patient to regain his respect and frees him from the loneliness he feels.

Apart from the time they devote to patient care, psychiatrists of the team spend a significant time on the floor. This presence helps to reduce patient anxiety, and stimulates a feedback mechanism between the team members who feel reassured.

The team welcomes all types of clinical pathologies without exeption and patients are neither selected nor grouped geographically in the floor according to their symptoms. References to the current psychiatric nosology, the DSM IV, the classical psychiatry and psychopathology psychotherapy gives our team a complementary perspectives that help identify the origin of the patient’s suffering and respond by means of the most appropriate treatment. Particular emphasis is given to bipolar disorder, more and more frequent.

For patients with addiction disorders, we do not have any ideal abstinence goal or a mission of “cleansing”. The withdrawal treatment is not the only tool used in care. The use of substitute products allows us to help patients regain balance in their addiction. However, we will not “idealize” substitutes and make them the only tool in the care of drug addicts. From the hospital management, we will seek with the patient, his family or his entourage socio-professional ways to strengthen the care given in the department. Taking into account the post hospitalization phase is mandatory to optimize the effects of hospital stay.

Continuing education for nurses and caregiver allows caregivers to take distance from the transfer of patients, and better control the therapeutic tools used in the service. This training is continuous with the head of department informally, during daily discussions on relationship problems posed by patients, at a weekly meeting for the passing from the night shift and day shift and finally in quarterly training sessions involving all team members.

The emergency hospitalization is harmonized between the psychiatric ward and the emergency. The organization is based on three essential points: the participation of the psychiatric department in emergencies, the admission at emergency department and the use of certain psychotropic drugs. Psychiatrists share the emergency duties alternating 24/24. The Head of Service can be reached at all times and throughout the year. As for the nursing staff, on arrival of any emergency psychiatric or suspicious patient, a nurse from the psychiatric ward moves to participate in the management. In the event of an agitated patient or which creates great anxiety among staff, the psychiatry nurse is accompanied by one or two caregivers (male preferred) from the psychiatry department.

Coordination is also ongoing with the Security Service of the Hospital. It allows the intervention of security guards in the best possible conditions to help health care providers, when necessary to bring calm to a troubled situation on the floor.

The collaboration with the Faculty of Medicine at the Lebanese University has been around for years and has been enforced by the fact that Mount Lebanon Hospital is has become a University Hospital. A resident is permanently assigned to the floor and the Department of Psychiatry at the Lebanese University is led by Dr. Wadih Naja, in collaboration with Dr. Ramzi Haddad.

Dr. Shawki Azouri, Chief of Psychiatry at Mount Lebanon Hospital teaches medical psychology.

Finally, the department collaborates with the St. Joseph University for training purposes. Trainee psychologists do their training under the supervision of the psychologist of the floor.