Patterns of Service Use in Intensive Case Management: A Six Year Longitudinal Study.
Détails
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_963E6E5C7BBC
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Patterns of Service Use in Intensive Case Management: A Six Year Longitudinal Study.
Périodique
Administration and policy in mental health
ISSN
1573-3289 (Electronic)
ISSN-L
0894-587X
Statut éditorial
Publié
Date de publication
09/2022
Peer-reviewed
Oui
Volume
49
Numéro
5
Pages
798-809
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
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.
Mots-clé
Case Management, Community Mental Health Services, Hospitalization, Humans, Length of Stay, Longitudinal Studies, Mental Disorders/diagnosis, Mental Disorders/therapy, Schizophrenia/therapy, Assertive community treatment, Intensive case-management, Patterns, Psychiatric hospitalization, Service use
Pubmed
Web of science
Open Access
Oui
Financement(s)
Université de Lausanne
Création de la notice
25/04/2022 9:08
Dernière modification de la notice
21/11/2022 9:23