Beyond the mental hospital: crisis intervention and continuity of care in Trieste. A four year follow-up study in a community mental health centre.
A sample group of 39 new patients with acute and severe crises underwent a 4-year follow-up study at the community mental health center in Trieste (CMHC). The CMHC is a full-time service, open 24 hours a day and 7 days a week, and is fully integrated into a network of services which has completely replaced the preexisting mental hospital. Evaluation shows: 1) a generally good outcome of the initial crisis; 2) a low relapse rate; 3) a tendency towards favourable long-term outcomes. In terms of practice, voluntary and compulsory hospitalization were avoided in favor of short-term day and night support in the CMHC. There were no suicides, no crimes, no drop-outs. Social adjustment remained unchanged. Accessibility and continuity of care were favored by not separating special crisis services. Instead, crisis intervention was integrated into a comprehensive Mental Health Service offering a wide range of preventive and rehabilitative responses. The study demonstrates that the mental health services in Trieste are able to cope with acute crises without psychiatric hospitalization.
Mezzina
R
R
Centro di Salute Mentale, Trieste, Italy.
Vidoni
D
D
D000328:Adult; D000368:Aged; D003156:Community Mental Health Services; D003266:Continuity of Patient Care; D003419:Crisis Intervention; D003431:Cross-Cultural Comparison; D003688:Deinstitutionalization; D005260:Female; D005500:Follow-Up Studies; D006297:Health Services Accessibility; D006801:Humans; D007558:Italy; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D010348:Patient Care Team; D012944:Social Support; D016896:Treatment Outcome