The mental health review board: a new concept for difficult clients.

1. The Mental Health Review Board concept is a hospital systems approach to the difficult client. Board membership varies with each case and includes representation from all areas of the hospital. 2. The Review Board deals with clients who have exhausted the system, are threatening or abusive to staff, and noncompliant with treatment recommendations. 3. The Review Board contract is the "final offer" for treatment and is without input from the client. Terms of the contract are nonegotiable. Noncompliance results in discharge and referral elsewhere.