There is a strong case for providing specialist services and structured clinics to manage bipolar disorder and mixed affective states, particularly to reduce suicide risk. Because mood can be very changeable in this disorder, especially in mixed affective states and rapid cycling bipolar disorder, the service must be responsive, implying that fixed occasional outpatient appointments might not constitute adequate management. A flexible approach is needed with a service that is tailored to the individual.
Keywords: bipolar disorders, suicide risk, design of services