Night beds in psychosocial attention care centers for alcohol and drugs: analysis and characterization

Abstract

Objective: To analyze and characterize the use of night beds in a Psychosocial Attention Care Center for Alcohol and Drugs (Centro de Atenção Psicossocial Álcool e Drogas – CAPS ad). Method: It is a quantitative, documental, descriptive and retrospective study. Data were gathered from 565 medical records. An analysis of continuous variables was performed. Results: When admitted to the beds, most users (87.6%) consumed multiple substances daily and were vulnerable, specially in street situation (68.3%). These users were admitted on an average of two times, undergoing a previous evaluation by the nurse (85.8%), usually for detoxication or due to the vulnerable condition. They stayed in the center for an average of seven days and 31.1% did not finish what was proposed. For a few cases, hospital support was needed. Overall, discharges were planned, but the return happened without booking. Conclusion: Social issues cut through the use of night beds, however, it is a therapeutic resource that meets significant demands and is present in the daily lives of vulnerable users as a comprehensive care.

Homelessness, crack use, and length of stay as predictors of planned discharge from night care in a Psychosocial Care Center

“…As independent/explanatory variables, those recognized by clinical practice and scientific literature were used 1,3,4,7,9,11 as factors that may interfere with the type of discharge: homelessness (yes or no), the substance used (alcohol, crack, cocaine and marijuana), the pattern of use (none, occasional, weekly or daily), medical and nursing evaluation for admission (yes or no), going to bed for detoxification (yes or no), length of stay proposed by the team and length of stay (numerical), need for hospital support during the night care embracement (yes or no), and hospitalization previous psychiatric (yes or no). It is worth mentioning that all these terms and criteria were reproduced following the template from paper records and patient documentation used in the CAPS.…”

“…Some phenomena related to the conduct of night care embracement emerged in the daily practice of services -they were not foreseen during their planning, organization, and operation 9,11 . The length of stay is one of them.…”

“…A typical result reflecting these practices is the early abandonment of care at night care embracement, with difficulty planning discharge between staff and users. Surveys show rates ranging from 15.3% to 36.2% of discharges without reception planning at the CAPS AD III, before the scheduled time, named discharges on request or evasion 11,12 . Additionally, current public policies do not value this model of care and disregard the necessary investments that must be made to improve and qualify this response, such as the training of teams and the expansion of resources 10 .…”

Psychosocial Healthcare Centres (CAPS) in Brazilian Mental Health Policy, 2008-2017

“…We have a national law, won by social Movements, which has been incorporated by society, judiciary branch, public managers. We have put in place a network that, although it still has gaps, extended the rights of users and their families and access to treatment under SUS [3] 11 .…”

“…Indeed, following the implementation of the Psychiatric Reform Law, psychosocial care encapsulated the primary provisions related to mental illness, alcohol and other drugs user care (AOD) 3 . Key elements of this mental health policy involved: a) reducing poor quality and expensive health care at both nancial and social levels; b) rejecting the previous service delivery model by diversifying therapeutic resources and promoting the decentralisation of care 14 which was believed to be the result "…of new political and cultural relations" 2 .…”