ABSTRACT
OBJECTIVE: The study analyses the number, characteristics and reasons for a length of stay of patients in German psychiatric clinics in excess of 6 months. METHODS: The study was implemented in the form of a nationwide online survey, which was addressed to chief physicians of psychiatric clinics. RESULTS: In the sample, 174 patients in 80 psychiatric clinics were identified who could not be discharged because no suitable follow-up services were available in the region. The majority of patients are male, often have an F2 diagnosis and exhibit aggressive behaviour during their hospital stay. CONCLUSION: To avoid inappropriate health care and prevent prolonged stays for a subgroup of mentally ill people, individual complex services should be implemented in community psychiatry.
ABSTRACT
OBJECTIVE: To assess COVID-19 pandemic-related changes in psychiatric and psychosocial services and their impact on the care of people with severe mental illness in two contrasting regions. METHODS: Development and use of an online questionnaire (PandA-Psy) in Leipzig (N=50) and Mecklenburg-Western Pomerania (N=126). RESULTS: In community psychiatric care, mostly comparable changes caused by the COVID-19 pandemic were observed in the two selected regions. These mainly concern the decrease in face-to-face contacts and group services, the increase in digital and telephone services, as well as the increasing constraints of staff. Differences between the regions are discussed. CONCLUSION: PandA-Psy was successfully used to map changes caused by the COVID-19 pandemic in psychiatric and psychosocial services in two areas. In addition to the predominantly negative consequences of the pandemic situation, we also found opportunities arising from the crisis.
Subject(s)
COVID-19 , Psychiatric Rehabilitation , Humans , Pandemics , SARS-CoV-2 , Germany , Surveys and QuestionnairesABSTRACT
BACKGROUND: The United Nations Convention on the Rights of Persons with Disabilities and the Federal Participation Act state that all human beings have the right to choose where to live. This human right is compromised by the institutional limitations of the community psychiatric system, where persons with severe mental illnesses and with intensive support needs are often housed in closed (i.e. physically locked) living contexts. How can the concept of person-centered care help to solve this conflict? OBJECTIVE: Description of the nationwide situation of closed residential facilities and discussion of the person-centered approach as a solution to the problem of closed living contexts. METHODS: Summary of current knowledge on the structural and procedural data of closed residential facilities in Germany, which were collated within the framework of the "Coercive measures in the psychiatric care system-Collation and reduction" (ZIPHER) study. RESULTS: The empirical data indicate a great need for regionally based care of the target group and a lack of individual arrangements as alternatives to closed living contexts. The necessity for regional care obligations is highlighted by the example of Mecklenburg-Western Pomerania. CONCLUSION: The avoidance and reduction of closed accommodation can primarily be achieved by individual arrangements within the framework of person-centered and flexible proposal landscapes. For this the service providers of integration assistance, including the psychiatric hospitals, must be committed to the care of all people in their region. An appropriate accompaniment and refunding by the service provider are also necessary.
Subject(s)
Disabled Persons , Mental Disorders , Germany , Humans , Mental Disorders/epidemiology , Mental Disorders/therapy , Patient-Centered Care , Residential FacilitiesABSTRACT
OBJECTIVE: Description of the nationwide housing situation for severely mentally ill people (including substance dependencies). METHODS: Nationwide quantitative survey using an online questionnaire on structural and process data of residential facilities. The survey was conducted as part of the "ZIPHER" study (coercive measures in the psychiatric help system - recording and reduction). RESULTS: A response rate of 20â% was achieved, 11,881 open and 1,268 closed home places were recorded. The present results show that especially male people, who are 50 years of age and older and/or suffering from schizophrenia are living in the psychiatric housing facilities. Both the composition of staff members during the day and the presence of staff at night differ between the open and closed living contexts. CONCLUSION: The first nationwide results refer to a lack of data in the field of inpatient housing facilities and the need for a regionally based social reporting.
Subject(s)
Mentally Ill Persons , Residential Facilities , Schizophrenia , Germany , Housing , Humans , Male , Middle AgedABSTRACT
OBJECTIVE: Description of the nationwide housing situation for severely mentally ill people (including substance dependencies). METHODS: Nationwide quantitative survey using an online questionnaire on structural and process data of residential facilities. RESULTS: A response rate of 20â% was achieved, 11,881 open and 1,268 closed home places were recorded. The empirical data refer to a lack of individual arrangements after living in a psychiatric housing facility and as an alternative to closed living contexts - even today people are still accommodated far away from their home. CONCLUSION: The high allocation from psychiatric inpatient units to closed housing facilities shows that there has to be a better control of aftercare by the community psychiatry in general and the inpatient units in particular. Required are individual residential arrangements for severely mentally ill that are appropriately funded.
