title: Promoting recovery via an integrated model of care to deliver a bed-based, mental health prevention and recovery centre.
abstract: OBJECTIVE
  This research was conducted in order to explore the experience of care and outcomes for people entering a bed-based step-up/step-down Prevention and Recovery Centre (PARC).
  
  
  METHODS
  An audit of files for PARC participants in 2010 collected demographic (age, gender, and marital, housing, employment and education/training status) and clinical measures (length of stay, entry and exit outcome measures, psychiatric hospital use). Participants were also invited to a feedback group to discuss their PARC experience.
  
  
  RESULTS
  In 2010, 118 people entered PARC. Most were single and unemployed and 35% were in temporary housing or homeless. In the six months following PARC exit, participants spent significantly less time in psychiatric hospital than in the six months prior to entry (p<0.001). Significant reductions in clinician-rated difficulties were documented at exit (p<0.001). For 40 episodes of care with self-report measures at entry and exit, significant reductions in difficulties with relating to self/others (p=0.004), daily living/role functioning (p=0.006), and depression/anxiety (p=0.019) were seen. Twelve participants attended a feedback group. Positive aspects of PARC included: supportive and caring staff; help with practical issues or community access; therapeutic activities and learning about health; and socialization opportunities.
  
  
  CONCLUSIONS
  A step-up/step-down PARC can facilitate recovery for people with mental illness through promoting independence and illness self-management.
authors.affiliation: Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred, Melbourne, VIC, Australia stuart.lee@monash.edu.
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Mental Illness Fellowship Victoria, Fairfield, VIC, Australia.
authors.forename: Laura
authors.initials: L
authors.lastname: Collister
authors.affiliation: Department of Psychiatry, The Alfred, Prahran, VIC, Australia.
authors.forename: Simon
authors.initials: S
authors.lastname: Stafrace
authors.affiliation: Mental Illness Fellowship Victoria, Fairfield, VIC, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Crowther
authors.affiliation: Department of Psychiatry, The Alfred, Prahran, VIC, Australia.
authors.forename: Jon
authors.initials: J
authors.lastname: Kroschel
authors.affiliation: Monash Alfred Psychiatry Research Centre, Central Clinical School, Monash University and The Alfred, Melbourne, VIC, Australia.
authors.forename: Jayashri
authors.initials: J
authors.lastname: Kulkarni
mesh_terms: D000293:Adolescent; D000328:Adult; D003155:Community Mental Health Centers / Q000592:standards*; D019033:Delivery of Health Care, Integrated / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000517:prevention & control / Q000628:therapy*; D008875:Middle Aged; D017060:Patient Satisfaction; D016896:Treatment Outcome; D055815:Young Adult
keywords: integrated care; mental health service; recovery-focused; step-up/step-down care