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Preventing compulsory admission to psychiatric inpatient care using psycho-education and monitoring: feasibility and outcomes after 12 months


Lay, Barbara; Blank, Christina; Lengler, Silke; Drack, Thekla; Bleiker, Marco; Rössler, Wulf (2015). Preventing compulsory admission to psychiatric inpatient care using psycho-education and monitoring: feasibility and outcomes after 12 months. European Archives of Psychiatry and Clinical Neuroscience, 265(3):209-217.

Abstract

The aim of this study was to evaluate an intervention programme for people with severe mental illness that targets the reduction in compulsory psychiatric admissions. In the current study, we examine the feasibility of retaining patients in this programme and compare outcomes over the first 12 months to those after treatment as usual (TAU). Study participants were recruited in four psychiatric hospitals in the Canton of Zurich, Switzerland. Patients were eligible if they had at least one compulsory admission during the past 24 months. Participants were assigned at random to the intervention or to the TAU group. The intervention programme consists of individualised psycho-education focusing on behaviours prior to illness-related crisis, crisis cards and, after discharge from the psychiatric hospital, a 24-month preventive monitoring. In total, 238 (of 756 approached) inpatients were included in the trial. After 12 months, 80 (67.2 %) in the intervention group and 102 (85.7 %) in the TAU group were still participating in the trial. Of these, 22.5 % in the intervention group (35.3 % TAU) had been compulsorily readmitted to psychiatry; results suggest a significantly lower number of compulsory readmissions per patient (0.3 intervention; 0.7 TAU). Dropouts are characterised by younger age and unemployment. This interim analysis suggests beneficial effects of this intervention for targeted psychiatric patients.

The aim of this study was to evaluate an intervention programme for people with severe mental illness that targets the reduction in compulsory psychiatric admissions. In the current study, we examine the feasibility of retaining patients in this programme and compare outcomes over the first 12 months to those after treatment as usual (TAU). Study participants were recruited in four psychiatric hospitals in the Canton of Zurich, Switzerland. Patients were eligible if they had at least one compulsory admission during the past 24 months. Participants were assigned at random to the intervention or to the TAU group. The intervention programme consists of individualised psycho-education focusing on behaviours prior to illness-related crisis, crisis cards and, after discharge from the psychiatric hospital, a 24-month preventive monitoring. In total, 238 (of 756 approached) inpatients were included in the trial. After 12 months, 80 (67.2 %) in the intervention group and 102 (85.7 %) in the TAU group were still participating in the trial. Of these, 22.5 % in the intervention group (35.3 % TAU) had been compulsorily readmitted to psychiatry; results suggest a significantly lower number of compulsory readmissions per patient (0.3 intervention; 0.7 TAU). Dropouts are characterised by younger age and unemployment. This interim analysis suggests beneficial effects of this intervention for targeted psychiatric patients.

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2 citations in Web of Science®
2 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Psychiatric University Hospital Zurich > Clinic for Psychiatry, Psychotherapy, and Psychosomatics
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2015
Deposited On:16 Jan 2015 13:34
Last Modified:05 Apr 2016 18:52
Publisher:Springer
ISSN:0940-1334
Publisher DOI:https://doi.org/10.1007/s00406-014-0553-1
PubMed ID:25361537

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