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depression, men present with problems that are more consistent with
aggression and impulsivity. It is vital to establish rapport with these
patients, since the psychiatrist may be their first contact with a mental
health professional.

Addicts tend to have a complicated presentation, mostly due to their
involvement with law agencies, dependency court, and unemployment.
Many are recently released from jail and have lost all of their
possessions. Not only do they have to deal with mental illness, but
also the realities of a complex legal and social structure that is very
demanding of their time and emotions. Some patients are also
homeless or staying in temporary housing. Indeed, their stress level is
high, sleep is often disrupted, and they may not have access to any
services let alone psychiatric treatment.

After an initial psychiatric work-up, a list of symptoms is generated
with the help and participation of the patient, which upon their
resolution, become the criteria for discharge. Patients are encouraged
to focus on their symptoms and discomfort, rather than diagnosis.

In an average year, 500 to 750 patients receive psychiatric
evaluation/treatment. Although the patients are told the program is
voluntary, the majority finishes the 3-4 months course with
improvement and achieves psychiatric stability. These patients are
then referred preferably to a primary-care physician for continued
medical care.

The Mood Disorders---Depression

The term Mood Disorders covers up to 70-75% of all psychiatric
presentations. This includes all types of depression, bipolar disorder
and the related anxiety and psychosis. They cause major financial
burden on the economy due to loss of productivity, lower immunity
and predisposition to health problems. Suicide and hospital stays cost
huge sums of money. The focus nowadays is to get these patients well
fast and achieve remission.