Service needs of individuals and populations

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Psychiatrists confront the issue of the need for mental health services at the clinical, or individual, level and also at the policy, or service system, level. At the clinical level, in order to provide a coherent and defensible treatment plan for an individual patient, a practitioner must make some formal or informal estimate of that person's needs. At the system level, when developing a plan for a specific population or allocating resources, planners must have some estimate of need in the community and the extent to which needs are being met, if rational planning is to occur. This chapter addresses concepts of need at both levels.

In clinical practice, estimates of the needs of individual patients are generally based on clinical judgement and translated informally into a prescription for clinical services for that person. At the system level, needs are often assumed, or estimates made pragmatically, because data to support them are unavailable. Increasingly, however, both in the clinical world and in the health-policy and management arena, quantitative need estimates derived by valid methods are being demanded.

Breaking Bulimia

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We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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