Question: What considerations go into deciding whether treatment for bipolar disorder should occur in a hospital or on an outpatient basis?
Answer: This is really a critical question -- where's the best place to take care of someone. Most of the time it boils down to safety.
If someone is potentially in danger of doing something to themselves -- if they're having thoughts of suicide, if someone is perhaps having thoughts of hurting someone else, or if someone's just so ill that they're not able to take care of themselves, then we'll often need to treat them in a hospital setting. Otherwise we do our very best to treat people in an outpatient setting and to keep them at home.
There are also intermediates between the inpatient and the outpatient settings -- so there are for example day programs where patients might go to the program, get treatment and then come home and stay in their own house.
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