Acute psychiatric care: approaches to increasing the range of services and improving access and quality of care

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dc.contributor.authorJohnson, Sonia
dc.contributor.authorDalton-Locke, Christian
dc.contributor.authorBaker, John
dc.contributor.authorHanlon, Charlotte
dc.contributor.authorSalisbury, Tatiana Taylor
dc.contributor.authorFossey, Matt
dc.contributor.authorNewbigging, Karen
dc.contributor.authorCarr, Sarah E.
dc.contributor.authorHensel, Jennifer
dc.contributor.authorCarra, Giuseppe
dc.contributor.authorHepp, Urs
dc.contributor.authorCaneo, Constanza
dc.contributor.authorNeedle, Justin J.
dc.contributor.authorLloyd-Evans, Brynmor
dc.date.accessioned2025-01-20T21:08:03Z
dc.date.available2025-01-20T21:08:03Z
dc.date.issued2022
dc.description.abstractAcute services for mental health crises are very important to service users and their supporters, and consume a substantial share of mental health resources in many countries. However, acute care is often unpopular and sometimes coercive, and the evidence on which models are best for patient experience and outcomes remains surprisingly limited, in part reflecting challenges in conducting studies with people in crisis. Evidence on best ap-proaches to initial assessment and immediate management is particularly lacking, but some innovative models involving extended assessment, brief interventions, and diversifying settings and strategies for providing support are potentially helpful. Acute wards continue to be central in the intensive treatment phase following a crisis, but new approaches need to be developed, evaluated and implemented to reducing coercion, addressing trauma, diversifying treatments and the inpatient workforce, and making decision-making and care collaborative. Intensive home treatment services, acute day units, and community crisis services have supporting evidence in diverting some service users from hospital admission: a greater understanding of how best to implement them in a wide range of contexts and what works best for which service users would be valuable. Approaches to crisis management in the voluntary sector are more flexible and informal: such services have potential to complement and provide valuable learning for statutory sector services, especially for groups who tend to be underserved or disengaged. Such approaches often involve staff with personal experience of mental health crises, who have important potential roles in improving quality of acute care across sectors. Large gaps exist in many low- and middle-income countries, fuelled by poor access to quality mental health care. Responses need to build on a foundation of existing community responses and contextually relevant evidence. The necessity of moving outside formal systems in low-resource settings may lead to wider learning from locally embedded strategies.
dc.fuente.origenWOS
dc.identifier.doi10.1002/wps.20962
dc.identifier.eissn2051-5545
dc.identifier.issn1723-8617
dc.identifier.urihttps://doi.org/10.1002/wps.20962
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/93453
dc.identifier.wosidWOS:000791742800009
dc.issue.numero2
dc.language.isoen
dc.pagina.final236
dc.pagina.inicio220
dc.revistaWorld psychiatry
dc.rightsacceso restringido
dc.subjectAcute care
dc.subjectmental health crises
dc.subjectinpatient psychiatric wards
dc.subjectemergency departments
dc.subjectcrisis houses
dc.subjectacute day units
dc.subjectcrisis resolution and home treatment teams
dc.subjectintensive home treatment
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAcute psychiatric care: approaches to increasing the range of services and improving access and quality of care
dc.typeartículo
dc.volumen21
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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