Unfortunately, many mental illnesses that psychiatrists treat cannot be cured, but the patient can be controlled. Therefore, as chronic conditions, it is expected that throughout the patient’s life and following the natural course of the illness, relapses will occur, mainly if stressful events have occurred in the patient’s life, such as the death of a loved one, job loss, relationship breakup, health problems, and very importantly, the discontinuation or irregular use of medication.

For centuries, it was believed that once a person was diagnosed with a mental illness, the next step was to confine them to a mental institution for the rest of their days. This gave rise to asylums, institutions that served as prisons for those with psychiatric problems for centuries, isolating them not only from their loved ones but also from any interaction with the outside world. It is common to hear stories of people who entered these institutions and spent the rest of their lives there.

As new treatment modalities were discovered for patients with conditions such as schizophrenia and bipolar disorder, among others, along with the emergence of socio-political movements and human rights advocacy, such as the Caracas Declaration on December 14, 1990, changes were proposed in the face of the distressing reality that thousands of mentally ill individuals were experiencing in Latin America. This led to the end of psychiatric hospitals as the sole form of care. Since then, more and more general hospitals have established psychiatric wards and services to address crises and relapses in patients with mental illness.

This brings us to today’s topic: When is it necessary to hospitalize a patient with a mental illness? Here is a list of signs and symptoms that family members should identify as soon as possible, as they represent a danger to the patient’s safety and, therefore, require hospitalization:

• Aggression towards objects, towards others, or oneself.
• Significant changes in sleep and eating patterns.
• Suicidal ideation or thoughts of death, as well as suicide attempts.
• Psychotic symptoms: Psychosis is a disconnection or loss of contact with reality. Individuals may experience auditory, visual, olfactory, or synesthetic hallucinations.
• Changes in behavior that may pose a risk to the patient’s safety include aimless wandering, uncontrolled sexual activities, and excessive and unnecessary spending.
• Side effects of treatment that could endanger the patient’s life, such as fever, stiffness, uncontrollable vomiting, or diarrhea.

The decision to hospitalize a patient always causes distress for the family. However, in most cases, crises are resolved within one to two weeks. It is recommended to recognize signs and symptoms of a potential relapse early, maintain a healthy lifestyle, adhere well to treatment, and maintain constant communication with the doctor to prevent hospitalization.