Is deinstitutionalization working in our community?

Hamden, Ann; Newton, Richard; McCauley-Elsom, Kay Madelon; Cross, Wendy

doi:10.1111/j.1447-0349.2010.00726.x

Cited by 30 publications

(26 citation statements)

References 33 publications

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“…Shifts in public policy towards the deinstitutionalisation of people with mental health conditions, in particular, and the more recent trend towards earlier discharge inpatient units have served to focus attention on the development of effective and efficient alternative models of care in community settings [1][2][3][4]. These models have been developed to foster the provision of care in the community, thus reducing the need for hospitalisation and its potentially negative impacts on consumers and their significant others.…”

Section: Introductionmentioning

confidence: 98%

The Impact of Integrating Crisis Teams into Community Mental Health Services on Emergency Department and Inpatient Demand

et al. 2016

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This investigation focused on the impact of integrating crisis team members into community mental health services on emergency department and adult mental health inpatient unit demand within an Australian public health service. Mixed methods were used including (a) the comparison of service use data with that of two other comparable services (both of which had community-based crisis teams), (b) surveys of (i) patients and carers and (ii) staff, and (c) focus groups with staff. The numbers of emergency department presentations with mental health conditions and adult mental health inpatient separations increased 13.9 and 5.7 %, respectively, from FY2006/07 to FY2012/13. Between the three services, there were minimal differences in the percentages of presentations with mental health conditions, the distribution of mental health presentations across a 24-h period, and the triage categories assigned to these patients. Survey participants reported that patients used the emergency department due to the urgency of situations, perceptions that gaining access to mental health services would take less time, and the unavailability of mental health services when help is needed. Staff identified several issues (e.g. inappropriate referrals) that may be unnecessary in increasing emergency department demand. The integration of crisis team members into community mental health services does not seem to have produced an increase in emergency department admissions or inpatient separations beyond what might be expected from population growth. The potential may exist, however, to reduce emergency department admissions through addressing the issue of inappropriate referrals.

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Section: Introductionmentioning

confidence: 98%

The Impact of Integrating Crisis Teams into Community Mental Health Services on Emergency Department and Inpatient Demand

et al. 2016

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“…Indeed, more recent research has suggested that evidence for the success of deinstitutionalization in Australia has not all been positive (Hamden, Newton, McCauley-Elsom, & Cross, 2011).…”

Section: Introductionmentioning

confidence: 99%

Where you live and who you live with matters: Housing and mental health

Moxham

2016

Journal of Prevention & Intervention in the Community

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“…Case management in community mental health has evolved since the 1960s following the deinstitutionalization of people with mental illness (Hamden et al . 2011; Muir‐Cochrane 2001; Rohde 1997).…”

Section: Introductionmentioning

confidence: 99%

“…2011; Muir‐Cochrane 2001; Rohde 1997). In Australia, for example, this policy shift gave rise to a rapid increase in the employment of community mental health nurses (Hamden et al . 2011).…”

Section: Introductionmentioning

confidence: 99%

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Community mental health nurses, caseloads, and practices: A literature review

Happell

Hoey²,

Gaskin

2011

Int J Mental Health Nurs

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Deinstitutionalization, and more recently, earlier discharges from psychiatric inpatient units, have created and intensified the need for case management in community mental health. Nurses have been at the forefront of providing this case management. This literature review provides a synthesis of research and policy on the contribution of mental health nurses to community case management. The focus of this review is on the proportion of case management that mental health nurses undertake, the caseloads of case managers, and the interventions that mental health nurses most frequently perform in the community. The professional compositions of mental health case management workforces have been associated with economic imperatives, professional priorities, and the choice of case management models. The influence of mental health nurses in the case management workforce is particularly strong in the U.K. and Australia, but less so in the U.S.A. where social workers and people without mental health qualifications perform similar roles. Although heavy caseloads seem to be common among case managers, the research in this area is quite weak. The interventions that mental health nurses perform most often include case management (e.g., coordinating care), counselling, and medication management. Caring for the physical health of consumers might often be overlooked.

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Is deinstitutionalization working in our community?

Cited by 30 publications

References 33 publications

The Impact of Integrating Crisis Teams into Community Mental Health Services on Emergency Department and Inpatient Demand

The Impact of Integrating Crisis Teams into Community Mental Health Services on Emergency Department and Inpatient Demand

Where you live and who you live with matters: Housing and mental health

Community mental health nurses, caseloads, and practices: A literature review

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