Intensive home support for mental health crises: experience of the Trieste territorial crises team, in Italy

Sade, Rossana Maria Seabra; Goljevscek, Serena; Corradi-Webster, Clarissa Mendonça

doi:10.1590/s0104-12902020190831

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…Podejście środowiskowe, oczywiste w teorii i deklarowane w programach ochrony zdrowia, wciąż boryka się z różnymi trudnościami na etapie realizacji. Zespoły mobilne są bardzo istotnym, innowacyjnym elementem środowiskowego modelu opieki psychiatrycznej, pełniącym wiodącą rolę w procesie zdrowienia osób z doświadczeniem kryzysu psychicznego (Sade, Goljevscek, Corradi-Webster, 2020). Zamysłu zespołów mobilnych można doszukiwać się w kształtującej się w przeszłości idei psychiatrii środowiskowej nastawionej na nieodrywanie człowieka od jego środowiska.…”

Section: Rola Zespołów Mobilnych W Zapobieganiu Hospitalizacji W śRod...unclassified

Zespoły mobilne a zapobieganie hospitalizacji w środowiskowym modelu opieki psychiatrycznej

Bartosiewicz-Niziołek

Błasiak²,

Olszewski

et al. 2021

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Powstanie zespołów mobilnych wiąże się z reformą psychiatrycznej opieki zdrowotnej i zmianie modelu leczenia z udzielania opieki w dużych szpitalach psychiatrycznych na rzecz działań realizowanych na poziomie społeczności lokalnej. Zespoły mobilne uzupełniają model podstawowy o usługi docierające do osób, które bez ich wsparcia mogłyby nie uzyskać pomocy, przez co są bardzo istotnym i innowacyjnym elementem środowiskowego modelu opieki psychiatrycznej, pełniącym wiodącą rolę w procesie zdrowienia osób z doświadczeniem kryzysu psychicznego. Głównym celem działalności zespołów mobilnych jest mobilizowanie osób z doświadczeniem kryzysu psychicznego do rozwiązywania swoich problemów w sytuacjach, w których jest to możliwe i osiągalne. W artykule przedstawiono kontekst historyczno-kulturowy wraz z rolą zespołów mobilnych w opiece psychiatrycznej. Przedstawiono korzyści płynące z udzielenia pomocy bezpośrednio w środowisku klienta oraz scharakteryzowano zadania zespołów mobilnych oraz ich współpracę z otoczeniem społecznym i asystentami zdrowienia.

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Section: Rola Zespołów Mobilnych W Zapobieganiu Hospitalizacji W śRod...unclassified

Zespoły mobilne a zapobieganie hospitalizacji w środowiskowym modelu opieki psychiatrycznej

Bartosiewicz-Niziołek

Błasiak²,

Olszewski

et al. 2021

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“…A equipe que aborda as situações de crise em casa realiza um trabalho em quatro fases: 1) inicia com a avaliação, 2) seguida de construção conjunta de um plano terapêutico, 3) envolver os familiares, até a fase 4) a ampliação de cuidados em equipamentos de acolhimento, se for o caso. O trabalho vem reduzindo consideravelmente a utilização de espaços hospitalares ou de acolhimento integral 11 .…”

Section: A Crise E a Articulação Da Atenção Em Redeunclassified

Abertura de possíveis no cuidado em saúde mental, em momentos de crise

Kinker

Moreira

2021

Saúde debate

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RESUMO O objetivo deste artigo é apontar possíveis ações em saúde mental, em momentos de crise, a partir da Rede de Atenção Psicossocial. Utilizou-se de cena ilustrativa para fundamentar a análise, a partir de diferentes concepções sobre o fenômeno. Evidencia-se que concepções hegemônicas e simplificadoras da crise psíquica são centralizadas em sinais e sintomas, e apagam os sentidos do episódio, gerando ações de violência para os envolvidos. Defende-se a busca por respostas complexas, a fim de ampliar possibilidades de entendimento e ação, envolvendo diferentes atores, que estão implicados na produção da cena da crise. Sugere-se uma abordagem amparada em diferentes pontos da rede psicossocial, visto que a manutenção dos laços comunitários é imperiosa e pode se transformar em espaços facilitadores para a aproximação ou manutenção da pessoa na comunidade. Conclui-se que as aberturas possíveis para o acolhimento e as ações em rede encontram limites nas concepções simplificadoras e contraditórias às necessidades das pessoas. Para lidar com a complexidade da crise, necessita-se de outro paradigma, outros olhares, práticas e saberes, que considerem que a pessoa que encarna a crise produz um significado, constrói um saber sobre a vida e sobre a própria crise, e não deve ser colocada no lugar de objeto de intervenção.

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“…On the one hand, studies on crisis resolution teams (CRT), a concrete model of IOC, conclude that staff continuity is crucial to service delivery ( 9 , 10 , 14 , 28 , 29 ). On the other hand, service users report to have seen too many staff involved in each episode of care, with contacts often being fleeting, superficial and requiring them to repeat their story several times ( 3 , 8 , 10 , 29–32 ).…”

Section: Introductionmentioning

confidence: 99%

How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis

et al. 2023

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BackgroundIntensive forms of outreach mental health care (IOC) such as crisis resolution or home treatment teams are increasingly implemented as alternatives to inpatient admission, providing recovery-oriented treatment at home at comparable costs and outcomes. However, one issue with IOC is the lack of continuity regarding staff members who provide home visits, complicating relationship building and meaningful therapeutic exchange. The aim of this study is to validate existing primarily qualitative findings using performance data and to explore a possible correlation between the number of staff involved within IOC treatment and the service users’ length of stay (LOS).MethodsRoutine data from an IOC team in a catchment area in Eastern Germany were analyzed. Basic parameters of service delivery were calculated and an in-depth descriptive analysis regarding staff continuity was performed. Further, an exploratory single case analysis was conducted, presenting the exact sequence of all treatment contacts for one case with low and one with high staff continuity.ResultsWe analyzed 10.598 face-to-face treatment contacts based on 178 IOC users. The mean LOS was 30.99 days. About 75% of all home visits were conducted by two or more staff members simultaneously. Service users saw an average of 10.24 different staff per treatment episode. On 11% of the care days, only unknown staff, and on 34% of the care days at least one unknown staff member conducted the home visit. 83% of the contacts were performed by the same three staff members and 51% were made by one and the same staff member. A significant positive correlation (p = 0.0007) was found between the number of different practitioners seen by a service user in the first seven days of care and the LOS.ConclusionOur results suggest that a high number of different staff in the early period of IOC episodes correlates with an extended LOS. Future research must clarify the exact mechanisms of this correlation. Furthermore, it should be investigated how the multiple professions within IOC teams influence the LOS and the quality of treatment and what quality indicators may be suitable to ensure treatment processes.

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Intensive home support for mental health crises: experience of the Trieste territorial crises team, in Italy

Cited by 3 publications

References 12 publications

Zespoły mobilne a zapobieganie hospitalizacji w środowiskowym modelu opieki psychiatrycznej

Zespoły mobilne a zapobieganie hospitalizacji w środowiskowym modelu opieki psychiatrycznej

Abertura de possíveis no cuidado em saúde mental, em momentos de crise

How to measure staff continuity in intensive psychiatric home treatment: a routine data and single case analysis

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