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Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring.
- Source :
-
BMC psychiatry [BMC Psychiatry] 2012 Sep 05; Vol. 12, pp. 136. Date of Electronic Publication: 2012 Sep 05. - Publication Year :
- 2012
-
Abstract
- Background: The high number of involuntary placements of people with mental disorders in Switzerland and other European countries constitutes a major public health issue. In view of the ethical and personal relevance of compulsory admission for the patients concerned and given the far-reaching effects in terms of health care costs, innovative interventions to improve the current situation are much needed. A number of promising approaches to prevent involuntary placements have been proposed that target continuity of care by increasing self-management skills of patients. However, the effectiveness of such interventions in terms of more robust criteria (e.g., admission rates) has not been sufficiently analysed in larger study samples. The current study aims to evaluate an intervention programme for patients at high risk of compulsory admission to psychiatric hospitals. Effectiveness will be assessed in terms of a reduced number of psychiatric hospitalisations and days of inpatient care in connection with involuntary psychiatric admissions as well as in terms of cost-containment in inpatient mental health care. The intervention furthermore intends to reduce the degree of patients' perceived coercion and to increase patient satisfaction, their quality of life and empowerment.<br />Methods/design: This paper describes the design of a randomised controlled intervention study conducted currently at four psychiatric hospitals in the Canton of Zurich. The intervention programme consists of individualised psycho-education focusing on behaviours prior to and during illness-related crisis, the distribution of a crisis card and, after inpatient admission, a 24-month preventive monitoring of individual risk factors for compulsory re-admission to hospital. All measures are provided by a mental health care worker who maintains permanent contact to the patient over the course of the study. In order to prove its effectiveness the intervention programme will be compared with standard care procedures (control group). 200 patients each will be assigned to the intervention group or to the control group. Detailed follow-up assessments of service use, psychopathology and patient perceptions are scheduled 12 and 24 months after discharge.<br />Discussion: Innovative interventions have to be established to prevent patients with mental disorders from undergoing the experience of compulsory admission and, with regard to society as a whole, to reduce the costs of health care (and detention). The current study will allow for a prospective analysis of the effectiveness of an intervention programme, providing insight into processes and factors that determine involuntary placement.
- Subjects :
- Adolescent
Adult
Aged
Humans
Middle Aged
Multicenter Studies as Topic economics
Multicenter Studies as Topic methods
Multicenter Studies as Topic standards
Patient Satisfaction economics
Power, Psychological
Quality of Life psychology
Randomized Controlled Trials as Topic economics
Randomized Controlled Trials as Topic methods
Randomized Controlled Trials as Topic standards
Switzerland
Young Adult
Coercion
Hospitals, Psychiatric economics
Inpatients psychology
Length of Stay economics
Mental Health Services economics
Patient Admission economics
Patient Admission standards
Psychotherapy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1471-244X
- Volume :
- 12
- Database :
- MEDLINE
- Journal :
- BMC psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 22946957
- Full Text :
- https://doi.org/10.1186/1471-244X-12-136