[On the necessity of improving the supply network for chronic alcoholics with multiple impairments].
OBJECTIVE
Description of care offers for chronic multiple handicapped dependents on alcohol in the service area of the clinic for psychiatry and psychotherapy of the district of Heidenheim and comparison with the situation on the supra-regional and national level ("Länder und Bund"). The present study aims at drawing attention to potential deficiencies as well as analysing the needs of the target group in order to suggest measures for improvement.


METHODS
Using a multi-perspective qualitative approach, the authors conducted interviews with experts from 15 institutions, services and associations of the area in question as well as semi-structured interviews with 16 patients undergoing qualified detoxification treatment. In addition, 14 patients being part of a group trying to prevent relapse into alcohol were interviewed to achieve triangulation.


RESULTS
With regard to the group of chronic alcoholics with multiple impairements care offers are deficient by reason of insufficient communication within the network of existing institutions, a lack that was also stated by studies carried out on a supra-regional and national level. There is no multi-professional office for coordination and cooperation, whose primary aim should be remedial measures will regard to the lack of home- and day-care treatment e.g. in hospital. Moreover, an inadequate situation as to organizing a patient's day and his leisure activities can be stated.


CONCLUSIONS
A case-management-model should be implemented into existing care structures. Patients in need of additional support ought to be given the possibility of day-care treatment. In this context the development of topic-centered qualification- and training programs is required, especially in the field of medical care. In the long run it will be necessary to realize a meeting place for dependents, run both by professionals and volunteers.
Hertrich
Ralf
R
Klinik für Psychiatrie und Psychotherapie, Kreiskrankenhaus Heidenheim, Germany.
Lutz
Sascha
S
D000437:Alcoholism / Q000453:epidemiology / Q000534:rehabilitation*; D019090:Case Management / Q000706:statistics & numerical data; D003156:Community Mental Health Services / Q000600:supply & distribution*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D017831:Diagnosis, Dual (Psychiatry); D005858:Germany / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D010348:Patient Care Team / Q000706:statistics & numerical data