Thanks again to everyone who responded. I’ve heard about the Parachute program but I don’t know anyone who has been involved with it. Does anyone reading this have any first-hand experience? I’d love to have that contact info if it’s operative and effective. I got the idea of creating a “hospital at home” from Jessica Arenella, President of ISPS-US. When our patients are in an extreme state, we make sure they’re safe at home, see or call them once or several times a day, help them and their families understand what’s happening, and offer meds and/or healing techniques of various kinds. It works very well, especially for people who have had mixed or bad experiences with hospitals in the past. I trained during the five minute period when psychodynamic understanding and medication were integrated and done by the same practitioners. Meds were used only for the most severe cases. Most people were treated with analytic understanding and family therapy. That model had problems of its own – the problem of blame. If you had a psychotic break, it was because you had a flawed ego and/or suffered at the hands of schizophrenogenic parents. When the medical model arrived, people felt liberated from blame. Whew, it’s just an illness! Problems in communication arose because our thinking and behavior was idiosyncratic and hard to understand, but it wasn’t necessary to begin from a position of self/other accusation. Believe it or not, that was liberating at the time. At the same time, Prozac arrived on the scene and the fantasy emerged that common ordinary unhappiness could be treated with a drug. That was a shared societal delusion, but it was pretty exciting at the time. I’m not sure what I’m trying to say… Maybe just offering some historical context for the serious problems we face today. I witnessed a change in tide once long ago, and I’m convinced that it will change again soon.