Background Although modern psychiatric services seek alternatives to hospitalisation wherever appropriate, the national trend toward higher bed occupancies on acute psychiatric wards has refocused attention on community-based alternatives and methods of assessing need for acute care.
Method We surveyed key decision-makers in a community-oriented district service with a low acute psychiatric bed to population ratio, in order to examine alternatives to hospitalisation in a cohort ofconsecutive admissions over a six-month period.
Results Alternatives to acute ward hospitalisation were identified for 29% of admissions, and for 42% ofthose with an admission duration of more than 60 days.
Residential options were chosen more often than intensive community support.
Simulated bed day savings were considerable.
Conclusions In a community-oriented service, key decision-makers could identify further alternatives to acute ward hospitalisation, although relatively few non-residential, community support options were chosen.
Although this methodology has limitations, data based upon key worker judgements probably have greater local'ownership'and the option appraisal process itself may challenge stereotyped patterns of resource use.
Mots-clés Pascal : Trouble psychiatrique, Traitement communautaire, Psychiatrie communautaire, Besoin, Santé, Royaume Uni, Europe, Santé mentale, Politique sanitaire, Homme, Alternative hospitalisation
Mots-clés Pascal anglais : Mental disorder, Community treatment, Community psychiatry, Need, Health, United Kingdom, Europe, Mental health, Health policy, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0274872
Code Inist : 002B18I11. Création : 15/07/1997.