Intensive home support for mental health crises: experience of the Trieste territorial crises team, in Italy

Abstract

Early management of mental health crises is important for a good prognosis and treatment adherence. Ideas have been proposed to address crisis situations at home, aiming to reduce hospitalizations and medication doses and to increase care satisfaction. Identifying experiences of home care for mental health crises can support managers and professionals in proposing innovative practices. This article aims to describe the experience of Trieste, in Italy, which implemented a home crisis team service. The work is carried out in four phases: application of the inclusion criteria for treatment by the crisis team; initial assessment; co-construction of the therapeutic plan; discharge and transition to other services. In one year, the team performed 124 assessments and provided care for 59 people. Regarding psychiatric symptoms, 93% of the patients showed significant improvement at discharge. Considering overall functioning, 81% showed significant improvement. Data show a reduction of compulsory admission rates of 29.4% in the first semester of 2018 and of 78.8% in the second semester, compared to 2017. The home crisis team achieved its goals of holistically caring for suffering individuals and reducing their contact with hospitals.

Zespoły mobilne a zapobieganie hospitalizacji w środowiskowym modelu opieki psychiatrycznej

“…Podejście środowiskowe, oczywiste w teorii i deklarowane w programach ochrony zdrowia, wciąż boryka się z różnymi trudnościami na etapie realizacji. Zespoły mobilne są bardzo istotnym, innowacyjnym elementem środowiskowego modelu opieki psychiatrycznej, pełniącym wiodącą rolę w procesie zdrowienia osób z doświadczeniem kryzysu psychicznego (Sade, Goljevscek, Corradi-Webster, 2020). Zamysłu zespołów mobilnych można doszukiwać się w kształtującej się w przeszłości idei psychiatrii środowiskowej nastawionej na nieodrywanie człowieka od jego środowiska.…”

Abertura de possíveis no cuidado em saúde mental, em momentos de crise

“…A equipe que aborda as situações de crise em casa realiza um trabalho em quatro fases: 1) inicia com a avaliação, 2) seguida de construção conjunta de um plano terapêutico, 3) envolver os familiares, até a fase 4) a ampliação de cuidados em equipamentos de acolhimento, se for o caso. O trabalho vem reduzindo consideravelmente a utilização de espaços hospitalares ou de acolhimento integral 11 .…”