Decrease of Hospitalizations and Length of Hospital Stay in Patients with Schizophrenia Spectrum Disorders or Bipolar Disorder Treated in a Mobile Mental Health Service in Insular Greece

Abstract

In recent years serious mental health issues, such as schizophrenia spectrum disorders and bipolar disorder, have been treated in the community by community-based mental health services. In the present study our goal was to estimate the modification in the number of hospitalizations and duration of admissions in either psychotic patients or patients with bipolar disorder, treated by a Mobile Mental Health Unit in the islands of Kefalonia, Zakynthos and Ithaca (MMHU-KZI). Data were collected from a total of 108 patients with schizophrenia spectrum disorders and bipolar disorder. For each patient comparison was made for the same time interval prior and after engagement to treatment with the MMHU-KZI and not for the total hospitalizations that patients had in their history. There was a statistically significant reduction (45.9%) in hospitalizations after treatment engagement with the MMHU-KZI, as the Wilcoxon signed ranks test indicated. Furthermore, a major decrease (54.5%) of hospitalization days was noted after treatment engagement with the unit. This pattern of mental health provision may be beneficial for the reduction of the number and duration of psychiatric hospitalizations. Despite the beneficial contribution of community-based mental health units, hospital based treatment should always be available, since severe relapses are better treated in inpatient setting.

Use of Long-Acting Injectable Antipsychotics in a Clinical Sample of Community-Dwelling Patients with Schizophrenia-Spectrum Disorders in Rural Greece

“…The number of hospitalizations did not differ statistically between the two groups of patients. It has been previously shown that treatment delivered by the MMHUs in rural Greece may reduce the number of hospitalizations, both voluntary and involuntary, as well as the length of hospital stay in patients with severe mental illness [ 45 , 46 ].…”

Difficult-to-Engage Patients with Severe Mental Illness in Rural Community Settings: Results of the Greek Hybrid Assertive Community Treatment Model of Mental Healthcare

“…For the estimation of the impact of the delivered care on patients' outcomes we applied a mirror image, prepost comparison of patients' outcome measures, i.e., hospitalizations, psychopathology and functioning, for the same interval prior and after engagement with the hybrid ACT care. This methodology has been previously used in research in community mental healthcare settings [24,31,32].…”

“…The MMHUs are integrated within the primary healthcare system and examine all referrals, with a special focus on patients with SMI [30]. There is preliminary evidence that the MMHUs may be effective in the treatment of both severe and common mental disorders and may reduce hospitalizations and disease-related disability [31][32][33]. Although previous research on SMI patients has shown that attendance rate with the MMHUs is satisfactory [34], still a substantial proportion, that is almost one-third disengage from care.…”

Mobile Mental Health Units in Greece: Bridging Clinical Practice and Research in the Rural Context

“…In general, research in the context of MMHUs is scarce and has been mostly conducted on islands [10][11][12] and on one site on the mainland [13][14][15][16]. Notably, most studies are single-center, which may limit the generalizability of their findings [17].…”