Community orientated treatment compared to psychiatric hospital orientated treatment

Hoult, John; Rosen, Alan; Reynolds, Ingrid

doi:10.1016/0277-9536(84)90272-7

Cited by 113 publications

(93 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…assertive mobile 7-day and night community-based mental health teams. [18][19][20] Further, community-based or domiciliary care [21][22][23] has been shown to be an important healing and abbreviating factor in aftercare following acute admissions for coronary care, strokes, renal dialysis, oncology, obstetrics, surgery and technical procedures of many types. 24,25 Health promotion, prevention, early detection and intervention Community Health Centres are the best local launching platform and base for health promotion, prevention and early intervention programs.…”

Section: Persistent Long-term and Recurrent Conditionsmentioning

confidence: 99%

“…Since the late 1960s, several waves of randomised-controlled trials have firmly established the superiority of 24-hour mobile community-based mental health care and aftercare, 18,48 and have been replicated convincingly in Australia. 19 Twenty-four hour consistent availability of services in the community has created the confidence that has prevented admissions to hospital and shortened length of stay. 19,49,50 Thus, with long-term fluctuating mental illnesses, only around 3% of the patients of the public sector mental health services are in 24-hour-nursed beds.…”

Section: The Lessons From Mental Health Servicesmentioning

confidence: 99%

“…19 Twenty-four hour consistent availability of services in the community has created the confidence that has prevented admissions to hospital and shortened length of stay. 19,49,50 Thus, with long-term fluctuating mental illnesses, only around 3% of the patients of the public sector mental health services are in 24-hour-nursed beds. 51,52 So public psychiatric clientele in treatment for persistent disorders are more than 32 times more community-based than hospitalbased.…”

Section: The Lessons From Mental Health Servicesmentioning

confidence: 99%

“…The evidence base for community versus hospital location of community mental health teams is limited, yet there is a consistent trend: while there is both direct and indirect evidence that community location and mobility generates better outcomes, 19,[48][49][50]56,57 no rigorous research study whatsoever favours locating community mental health services on hospital sites. Insistence by some state governments that the location of community mental health services in hospitals makes no difference to their quality, relies largely on anecdotal accounts from hospital-based managers and clinicians who presided over their retraction.…”

Section: The Lessons From Mental Health Servicesmentioning

confidence: 99%

“…45 However, this has been better studied in mental health care, where comprehensive 24-hour mobile communitybased alternative care has been demonstrated to lower family burden, and increase families' satisfaction with care (e.g. Hoult et al 19 ). While control studies clearly favour community-sited psychiatric services, they mainly dezzmonstrate better quality of life outcomes (e.g.…”

Section: Limitations Of the Evidencementioning

confidence: 99%

See 4 more Smart Citations

The future of community-centred health services in Australia: lessons from the mental health sector

Rosen

Gurr

Fanning

2010

Aust. Health Review

Self Cite

View full text Add to dashboard Cite

Abstract* It is apparent that hospital-dominated health care produces limited health outcomes and is an unsustainable health care system strategy. * Community-centred health care has been demonstrated to be a more cost-efficient and cost-effective alternative to hospitalcentred care, particularly for prevention and care of persistent, long-term or recurrent conditions. Nevertheless, hospitalcentred services continue to dominate health care services in Australia, and some state governments have presided over a retreat from, or even dismantling of, community health services. * The reasons for these trends are explored. * The future of community health services in Australia is uncertain, and in some states under serious threat. We consider lessons from the partial dismantling of Australian community mental health services, despite a growing body of Australian and international studies finding in their favour. * Community-centred health services should be reconceptualised and resourced as the centre of gravity of local, effective and affordable health care services for Australia. A growing international expert consensus suggests that such communitycentred health services should be placed in the centre of their communities, closely linked or collocated where possible with primary health care, and functionally integrated with their respective hospital-based services.What is known about the topic? Community-centred health care has been widely demonstrated to be a more cost-efficient and cost-effective alternative to hospital-centred care, particularly for prevention and care of persistent, long-term or recurrent conditions, e.g. in mental health service systems. A growing international expert consensus suggests that such communitycentred health services should be placed in the centre of their communities, closely linked or collocated where possible with primary health care, and functionally integrated with their respective hospital-based services. What does this paper add? Despite this global consensus, hospital-centred services continue to dominate health care services in Australia, and some state governments have presided over a retreat from, or even dismantling of, community health services. The reasons for these trends and possible solutions are explored. What are the implications for practitioners? Unless this trend is reversed, the loss of convenient public access to community health services at shopping and transport hubs and the consequent compromising of intensive home-based clinical care, will lead to a deterioration of preventative interventions and the health care of long-term conditions, contrary to international studies and reviews.

show abstract

Section: Persistent Long-term and Recurrent Conditionsmentioning

confidence: 99%

Section: The Lessons From Mental Health Servicesmentioning

confidence: 99%

Section: The Lessons From Mental Health Servicesmentioning

confidence: 99%

Section: The Lessons From Mental Health Servicesmentioning

confidence: 99%

Section: Limitations Of the Evidencementioning

confidence: 99%

See 3 more Smart Citations

The future of community-centred health services in Australia: lessons from the mental health sector

Rosen

Gurr

Fanning

2010

Aust. Health Review

Self Cite

View full text Add to dashboard Cite

show abstract

Identifying factors affecting the placement of mentally ill patients

O’Shea

Hughes

O'Reilly

1999

J. Mental Health Policy Econ.

View full text Add to dashboard Cite

Organizing mental health services: an evidence-based approach

Goldman

Thelander

Westrin

2000

J. Mental Health Policy Econ.

View full text Add to dashboard Cite

Background and Aims. Health policy makers and program developers seek evidence-based guidance on how to organize and finance mental health services. The Swedish Council on Technology Assessment in Health Care (SBU) commissioned a conceptual framework for thinking about health care services as a medical technology. The following framework was developed, citing empirical research from mental health services research as the case example. Framework. Historically, mental health services have focused on the organization and locus of care. Health care settings have been conceptualized as medical technologies, treatments in themselves. For example, the field speaks of an era of 'asylum treatment' and 'community care'. Hospitals and community mental health centers are viewed as treatments with indications and 'dosages', such as length of stay criteria. Assessment of mental health services often has focused on organizations and on administrative science.There are two principal perspectives for assessing the contribution of the organization of services on health. One perspective is derived from clinical services research, in which the focus is on the impact of organized treatments (and their most common settings) on health status of individuals. The other perspective is based in service systems research, in which the focus is on the impact of organizational strategies on intermediate service patterns, such as continuity of care or integration, as well as health status. Methods. Examples of empirical investigations from clinical services research and service systems research are presented to demonstrate potential sources of evidence to support specific decisions for organizing mental health services. Results. Evidence on organizing mental health services may be found in both types of services research. In clinical services research studies, service settings are viewed as treatments (e.g. 'partial hospitalization'), some treatments are always embedded in a service matrix (e.g. assertive community treatment), and, where some treatments are organizationally combined (e.g. 'integrated treatment' for co-occurring mental disorder and substance abuse), sometimes into a continuum of care. In service system research, integration of services and of the service system are the main focus of investigation. Studies focus on horizontal and vertical integration, primary care or specialty care and local mental health authorities-each of which may be conceptualized as a health care technology with a body of evidence assessing its effectiveness.

show abstract

Community orientated treatment compared to psychiatric hospital orientated treatment

Cited by 113 publications

References 4 publications

The future of community-centred health services in Australia: lessons from the mental health sector

The future of community-centred health services in Australia: lessons from the mental health sector

Identifying factors affecting the placement of mentally ill patients

Organizing mental health services: an evidence-based approach

Contact Info

Product

Resources

About