I tend to write pretty long notes, so take that for what you will. I enjoy writing notes and can type pretty quickly, so long notes for me aren't a problem. I tend to use as many quotes as possible (and as are relevant to what's going on) in the HPI. I think quotes provide a better picture of what's going on then summaries - not that there's anything wrong with summaries. Ultimately I think the same care can be provided, but quotes help me with a picture of the patient if I happen to go back and read them again in the future. I agree with
@F0nzie in that I try and write an HPI that forms as coherent a story as possible, and my HPI is structured in such a way. I typically use the same outline for all of my HPIs:
Paragraph #1: 1-liner, circumstances surrounding hospitalization (if on an inpatient service), brief summary of hospital course (if seen on a consult), or the problem that resulted in them coming to see a psychiatrist (if an outpatient visit)
Paragraph #2: information about the chief complaint(s); e.g., if anxiety, then information about the anxiety; if depression, then information about that; if SI, information about that, etc.; any relevant psychosocial stuff also goes in here
Paragraph #3: psychiatric ROS; the detail of this depends on the patient/presenting complaints but pretty much always includes depression screening, psychosis screening, and anxiety screening; might be more detailed if I'm worried about something else
Paragraph #4: issues related to treatment - e.g., patient's reported goals for treatment (inpatient/outpatient treatment), issues they'd like addressed by the consult service (C/L patient), treatments they are amenable to doing (medications, psychotherapy, PHP/IOP/substance rehab, etc.) as appropriate and relevant for the presenting issue
I will typically include more information if there is a safety concern, issues surrounding capacity, or if I'm challenging a historical or presumed diagnosis.