Balancing hospital and community treatment: effectiveness of an extended-hours community mental health team in a semi-rural region of australia
| Autor: | Daphne Habibis, Mike Hazelton, Rosemary Schneider, John Davidson, Alison Bowling |
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| Rok vydání: | 2003 |
| Předmět: |
Patient Care Team
Psychiatric Status Rating Scales Time Factors Mental Disorders Public Health Environmental and Occupational Health Hospitals District Hospitals General Community Mental Health Services Community-Institutional Relations Self Concept Tasmania Crisis Intervention Models Organizational Outcome Assessment Health Care Humans Health Services Research Longitudinal Studies Rural Health Services Family Practice Attitude to Health Case Management Qualitative Research Program Evaluation |
| Zdroj: | The Australian journal of rural health. 11(4) |
| ISSN: | 1038-5282 |
| Popis: | To examine the effectiveness of the introduction of a community mental health team on consumer psychosocial outcomes.Longitudinal panel design.District general hospital in a semi-rural region of Australia.Two matched groups (n = 37 in each group)These included: Brief Psychiatric Rating Scale (BPRS), Global Assessment Scale (GAS), Rosenberg Self-Esteem, Life Skills Profile as well as self-report.The study found that the introduction of the new service resulted in few significant differences in consumer outcomes.The paper argues that because the state was the only specialist mental health service provider and it was unable to offer assertive community treatment, hospital care remained central. Evidence that a substantial proportion of consumers and carers preferred hospital to community care is placed against this background. The paper argues that in regions like these, where community-based services are likely to remain underdeveloped, it may be best to maintain quality hospital services and to target community services more precisely on what is achievable rather than developing community services at the expense of hospital care.Studies on the efficacy of assertive community treatment suggest that it can lead to improved consumer outcomes. However, these studies are usually in urban settings and involve experimental teams. In many rural and regional areas community treatment teams offer standard rather than assertive community care. It is therefore important to investigate the effectiveness of community treatment teams in rural and regional Australia.This study suggests that in rural and regional areas characterised by limited resources, it is too much to expect community treatment teams to have a measurable impact on consumer outcomes. In these settings hospital care remains at the heart of the service. This means that regions such as these need to focus their community services on what is achievable given the level of resources and social ecology. For example, they may need to consider offering either crisis intervention or rehabilitation services and to rely on innovations, such as telehealth or strategic alliances with other service providers to fill the gap. |
| Databáze: | OpenAIRE |
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