The Effect of a New Integrated Mental Health Service on Hospitalisation

Abstract

The hypotheses of this study were supported by the results. Twelve beds were subsequently closed as a result of the efficiencies generated by integration. These findings support the model of true integration trailled here.

The Measurement of Improvement During Hospitalisation for Acute Psychiatric Illness

“…In Geelong, the public mental health services are provided by an 'integrated team' approach [10] whereby a single multidisciplinary team of mental health workers is responsible for the care and management of patients both in hospital and in the community. Over a 15-week period, from April to August 1997, staff assessed all inpatients within a few days of admission and again within a few days of discharge using version 4 of the HoNOS [2].…”

Continuity Across Inpatient and Outpatient Mental Health Care or Specialisation of Teams? A Systematic Review

“…No randomized controlled trials were identified. There were 13 non-randomized comparative studies which compared outcomes of continuity and specialisation systems [2,1,14,16,19–22,26,27,30,29,31,36–38,40], three survey studies which investigated patient and staff views towards continuity and specialisation systems [3,15,35], and one qualitative semi-structured interview study on staff views towards the two systems [17].…”

“…Of the 13 non-randomized comparative studies, one was a cluster non-randomized controlled trial (NRT) [16,19] which compared patient outcomes in an assertive community treatment service with continuity across inpatient and outpatient care, to standard care with separate inpatient and outpatient services. One study was a controlled before and after study (CBA) [26] which compared service level data (consisting of separate samples before and after) following the integration of an inpatient ward with outpatient services whilst a control site maintained separate specialised services. Three cohort studies [22,37,38,40] followed patients over time and compared outcomes of those treated in continuity systems and specialisation systems.…”

“…This ranged from comparing systems in which all staff members either worked across inpatient and outpatient settings or within one particular setting; to consultant-based systems (mainly in the UK) which focused only on continuity versus specialisation of consultant psychiatrists. The majority of studies collected data on psychiatric patients [2,1,14,16,19,20,22,26,27,30,29,31,36–38,40,3], although three focused on staff [21,15,17], and one study included both patients and staff [35].…”

“…One study was a controlled before and after study (CBA) [26] which compared service level data (consisting of separate samples before and after) following the integration of an inpatient ward with outpatient services whilst a control site maintained separate specialised services. Three cohort studies [22,37,38,40] followed patients over time and compared outcomes of those treated in continuity systems and specialisation systems.…”