dc.contributor.author
Wullschleger, Alexandre
dc.contributor.author
Berg, Juergen
dc.contributor.author
Bermpohl, Felix
dc.contributor.author
Montag, Christiane
dc.date.accessioned
2018-06-08T10:58:27Z
dc.date.available
2018-05-24T10:58:55.466Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/21412
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-24705
dc.description.abstract
Intensive outpatient models of need-adapted psychiatric care have been shown
to reduce the length of hospital stays and to improve retention in care for
people with severe mental illnesses. In contrast, evidence regarding the
impact of such models on involuntary hospital treatment and other coercive
measures in inpatient settings is still sparse, although these represent
important indicators of the patients' wellbeing. In Germany, intensive models
of care still have not been routinely implemented, and their effectiveness
within the German psychiatric system is only studied in a few pioneering
regions. An innovative model of flexible, assertive, need-adapted care
established in Berlin, Germany, in 2014, treating unselected 14% of the
catchment area's patients, was evaluated on the basis of routine clinical
data. Records of n = 302 patients diagnosed with severe mental disorders, who
had been hospitalized at least once during a 4-year-observational period, were
analyzed in a retrospective individual mirror-image design, comparing the 2
years before and after inclusion in the model project regarding the time spent
in hospital, the number and duration of involuntary hospital treatments and
the use of direct coercive interventions like restraint or isolation. After
inclusion to the project, patients spent significantly less time in hospital.
Among patients treated on acute wards and patients with a diagnosis of
psychosis, the number of patients subjected to provisional detention due to
acute endangerment of self or others decreased significantly, as did the time
spent under involuntary hospital treatment. The number of patients subjected
to mechanical restraint, but not to isolation, on the ward decreased
significantly, while the total number of coercive interventions remained
unchanged. Findings suggest some potential of intensive models of need-adapted
care to reduce coercive interventions in psychiatry. However, results must be
substantiated by evidence from randomized-controlled trials and longer
observation periods.
en
dc.rights.uri
http://creativecommons.org/licenses/by/4.0/
dc.subject
need-adapted care
dc.subject
assertive community treatment
dc.subject
intensive case management
dc.subject
outpatient care
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit
dc.title
Can “Model Projects of Need-Adapted Care” Reduce Involuntary Hospital
Treatment and the Use of Coercive Measures?
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation
Front. Psychiatry. - 9 (2018), Artikel Nr. 168
dcterms.bibliographicCitation.doi
10.3389/fpsyt.2018.00168
dcterms.bibliographicCitation.url
http://doi.org/10.3389/fpsyt.2018.00168
refubium.affiliation
Charité - Universitätsmedizin Berlin
de
refubium.mycore.fudocsId
FUDOCS_document_000000029786
refubium.note.author
Der Artike wurde in einer reinen Open-Access-Zeitschrift publiziert.
refubium.resourceType.isindependentpub
no
refubium.mycore.derivateId
FUDOCS_derivate_000000009755
dcterms.accessRights.openaire
open access