Intensive Home Treatment for Acute Mental Disorders: An Alternative to Hospitalization
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In 1978, I became the medical director of a general hospital psychiatric unit serving the twin cities of Kitchener/Waterloo in southwestern Ontario, Canada. Over the next four years, population growth accelerated, and more psychiatrists joined the department, both of which resulted in increasing pressure on beds. We reached a point where patients had to wait a dangerously long time to be admitted.
The provincial Ministry of Health policy was clear: no more funding for hospital beds only funding for community programs. I couldn’t see a way forward. An acute day hospital did not seem feasible; most of our patients were too ill to reliably attend, and public transportation is poor. There were no workable models for a crisis residence at that time.
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Borderline Personality Disorder, or BPD, is the most common personality disorder in Australia, affecting up to 5% of the population at some stage, and Flinders University researchers warn more needs to be done to meet this high consumer needs.
A new study in the
Journal of Psychiatric and Mental Health Nursing (Wiley) describes how people with BPD are becoming more knowledgeable about the disorder and available treatments, but may find it difficult to find evidence-based help for their symptoms.
The South Australian psychiatric researchers warn these services are constrained by stigma within health services and from health professionals, with inadequate funding for BPD treatments and general health policies leaving consumers struggling to find appropriate help.
Ease of use
Most respondents who answered the question on ease of use agreed or strongly agreed that Patientrack was easy to use (Fig 2). However, 47% (27 out of 57) reported that using the system took longer than the paper version; this finding has been explored further in a subsequent study, which is yet to be published. It appears staff valued Patientrack, as 66% of respondents (36 out of 54) felt it should be rolled out to the rest of the hospital.
Clinical areas that frequently use bank or agency staff reported finding it challenging, at times, to ensure appropriately trained staff were available to record patients’ vital signs on the electronic system. Technical challenges (for example, passwords expiring and problems accessing log-in details) were also reported; these prevented some staff members from electronically recording vital signs.
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