Patterns of Service Use in Intensive Case Management: A Six Year Longitudinal Study.

Details

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_963E6E5C7BBC
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Patterns of Service Use in Intensive Case Management: A Six Year Longitudinal Study.
Journal
Administration and Policy in Mental Health and Mental Health Services Research
Author(s)
Golay P., Bonsack C., Silva B., Pauli G., de Boer E., Morandi S.
ISSN
0894-587X (print)
1573-3289 (electronic)
ISSN-L
0894-587X
Publication state
In Press
Peer-reviewed
Oui
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
An Intensive Case Management (ICM) intervention has been developed in Lausanne, Switzerland. It aims to promote access to care for people with severe mental disorders who have difficulties to engage with mental health services because of the severity of their disorders and/or their marginality. ICM embrace components of assertive community treatment and critical time intervention. It is time limited and focused on critical phases of recovery. The goal of this study was to examine the heterogeneity of service use patterns of people who required ICM interventions and identify differences in patterns of duration and timing of the intervention. Records of 471 patients from the Department of Psychiatry of Lausanne University Hospital for whom the ICM team intervention was requested were analysed over a 6 year period with discrete sequential-state analysis. Trajectories could be split between six meaningful clusters including service light use and critical time intervention (58.0%), transition to long-term regular ambulatory-care (11.3%), partial transition to ambulatory care (14.4%), alternative to hospitalization (10.4%), continued ICM (4.9%) and long hospital stays (1.1%). Diagnoses of substance abuse were overrepresented among heavy users and diagnoses of schizophrenia were the most frequent diagnostic overall. Profiles of service use for ICM patients were very diverse. Long term interventions were frequently not necessary. A time-limited intervention was likely sufficient to stabilize the situation and/or engage the patient in care. A small number of situations required a sustained and long-term investment and did not always allowed for a reduction in the need for hospitalization. A general reflection on alternatives to hospitalization must be pursued, in particular for these patients.
Keywords
Psychiatry and Mental health, Public Health, Environmental and Occupational Health, Health Policy, Pshychiatric Mental Health, Assertive community treatment, Intensive case-management, Patterns, Psychiatric hospitalization, Service use
Pubmed
Open Access
Yes
Funding(s)
University of Lausanne
Create date
25/04/2022 9:08
Last modification date
16/06/2022 6:36
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