Patients’ experiences and satisfaction with home treatment for acute mental illness: a mixed-methods retrospective study

Mötteli, Sonja; Schori, Dominik; Menekse, Jasmin; Jäger, Matthias; Vetter, Stefan

doi:10.1080/09638237.2020.1803233

Cited by 8 publications

(8 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Existing studies show that the presence of a large number of unknown and alternating practitioners is experienced by service users as stressful, unsettling, and in some cases disruptive to the treatment situation, and stands in the way of the development of a recovery-oriented therapeutic relationship ( 3 , 8 , 10 ). This, in turn, has a negative effect on the service users’ satisfaction regarding the treatment ( 33 ).…”

Section: Discussionmentioning

confidence: 99%

“…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 ). A recent survey of patient satisfaction among users of psychiatric Home-Treatment (HT) identified poor staff continuity as one of the key sources of dissatisfaction ( 33 ). Although best practice guidelines and a fidelity scale for CRTs demand a named key worker, about which service users should be informed ( 14 , 34 ), a recent implementation study carried out in 75 CRTs in the UK shows an average of poor fidelity to the model for staff CoC, indicating a need for improvement ( 35 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2023

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

View full text Add to dashboard Cite

show abstract

“…It allows the acute treatment of up to 30 patients at the same time. This service provides an equivalent alternative to inpatient treatment for patients with acute mental disorders (Mötteli et al, 2018(Mötteli et al, , 2020. Patients should be between 18 and 65 years old, capable to make agreements, and with a permanent residence in the municipality of Zurich or adjacent districts.…”

Section: Settingmentioning

confidence: 99%

“…The mobile and multi-professional HT teams provide intensive care in the patients’ homes including up to several visits a day with 24/7 accessibility. HT has been proven to be an effective treatment option (Murphy et al, 2015; Stulz et al, 2019) with high treatment satisfaction (Morant et al, 2017; Mötteli et al, 2020). Furthermore, during the spread of the COVID-19 pandemic, home-based treatment approaches were particularly helpful for psychiatric patients when inpatient treatment was limited due to various reasons (Garriga et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…For instance, in Switzerland, although clinical and cost effectiveness was demonstrated for HT services (Mötteli et al, 2018; Stulz et al, 2019) their implementation in routine care is only slowly progressing due to a lack of financial coverage of some healthcare providers (Stocker et al, 2018). This results in an underutilisation of HT services despite of the high satisfaction in patients (Mötteli et al, 2020). For a better utilisation of HT as a routine in mental healthcare, it is important to know how it is accepted and known among potential referring healthcare professionals.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Knowledge and attitude towards home treatment among referring healthcare professionals and self-referring patients to a psychiatric hospital: Better information is needed

Mötteli

Risch

Hotzy

et al. 2021

Int J Soc Psychiatry

Self Cite

View full text Add to dashboard Cite

Background: Home treatment (HT) is a patient-centred and cost-effective alternative to acute psychiatric inpatient care. However, the progress of its implementation and utilisation in routine care is slow. Aims: The aim of this study was to examine the knowledge and attitude towards HT among healthcare professionals. Method: This observational study included telephone-based semi-structured interviews of 140 referring healthcare professionals including 35 self-referring patients to a large psychiatric hospital in Switzerland during 6 months in 2020. We assessed their knowledge, attitude and experience with HT along with sociodemographic characteristics, professional background and the intention for the referral. We completed the interviews with routine medical data of the referred patients such as diagnoses or symptom severity. Results: Regarding referrals for inpatient treatment (involuntary and voluntary), half of the referring healthcare professionals and 80% of the self-referring patients had no prior experience or knowledge of HT. Knowledge of HT differed in the order of the participants’ working places. We found that most participants were uncertain about the inclusion/exclusion criteria for HT. Despite the low levels of knowledge, attitudes towards HT were overall positive. Conclusions: Our results indicate that a proportion of the patients referred for inpatient treatment might have been eligible for HT too. The referring healthcare professionals’ and patients’ unfamiliarity and uncertainty with HT seems to be an important reason that home-based treatment approaches are still underused, although they are viewed very positively. Besides providing more information to potential referring health professionals, psychiatric hospitals should always carry out a standardized evaluation if HT is an option in patients who are referred for inpatient treatment.

show abstract

Stößt die Behandlung zu Hause auf größere Zufriedenheit? Ergebnisse zur Zufriedenheit der an der Behandlung beteiligten Personengruppen im Rahmen der multizentrischen AKtiV-Studie

Längle,

Raschmann,

Heinsch

et al. 2023

Psychiatr Prax

View full text Add to dashboard Cite

ZusammenfassungDieses Teilprojekt der AKtiV-Studie untersucht die Behandlungszufriedenheit von Patient*innen und Angehörigen und deren Belastungserleben in stationsäquivalenter und vollstationärer Behandlung. Zusätzlich wird die Arbeitszufriedenheit und -belastung von StäB Mitarbeitenden berücksichtigt. Relevante Parameter wurden über etablierte sowie neu adaptierte Fragebögen am Behandlungsende erhoben. Patient*innen und Angehörige in StäB sind signifikant zufriedener. Das Belastungserleben der Angehörigen reduziert sich in beiden Behandlungsformen. StäB Mitarbeitende sind allgemein sehr zufrieden, wobei kein Zusammenhang mit der Zufriedenheit von Angehörigen und Patient*innen besteht. In der Diskussion der Ergebnisse sind die bekannten Limitationen von Zufriedenheitsbefragungen zu beachten. Dennoch ermutigen die Ergebnisse dazu, diese für Deutschland neue Behandlungsform weiterzuentwickeln und zu verbreiten.

show abstract

Patients’ experiences and satisfaction with home treatment for acute mental illness: a mixed-methods retrospective study

Cited by 8 publications

References 32 publications

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

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

Knowledge and attitude towards home treatment among referring healthcare professionals and self-referring patients to a psychiatric hospital: Better information is needed

Stößt die Behandlung zu Hause auf größere Zufriedenheit? Ergebnisse zur Zufriedenheit der an der Behandlung beteiligten Personengruppen im Rahmen der multizentrischen AKtiV-Studie

Contact Info

Product

Resources

About