Impacts of implementing a forensic treatment mall: A program evaluation

Krystle Martin, K. Bickle, P. Leung, Danielle DaCosta, Brandon Joice
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Abstract

Psychiatric in-patients need programming and clinical interventions to support recovery and gradual re-integration into the community. Treatment malls are designed to meet these needs by offering psychosocial, person-centred rehabilitation groups in a centralized setting. Evidence suggests this treatment model increases patient engagement, broadens social networks, and improves functioning. Given this, our hospital implemented a treatment mall in our forensic services department in 2018. Because this was a new initiative at our hospital and the lack of outcome data on treatment malls in Canada, we conducted a program evaluation to explore the effects of the treatment mall and identify possible areas of improvement. Guided by a logic model, this evaluation used a retrospective chart review. Variables of interest included patient engagement, psychotropic pro re nata (PRN) administration, recovery scores, time spent off unit, elopement, use of restraints and seclusion, and patient activity levels. We assessed whether these changed post-implementation of the treatment mall. The results provide preliminary evidence of the positive effects of the treatment mall. Patient engagement and time spent off unit increased. Maintenance of changes and long-term outcomes remain to be seen; however, this evalua - tion provides support for the continued use and investigation of the treatment mall for our forensic services department.
实施法医治疗中心的影响:一个项目评估
精神病住院病人需要规划和临床干预,以支持康复和逐渐重新融入社区。治疗中心旨在通过在集中环境中提供以人为本的社会心理康复小组来满足这些需求。有证据表明,这种治疗模式增加了患者的参与度,扩大了社会网络,并改善了功能。鉴于此,我院于2018年在法医科实施了治疗中心。由于这是我们医院的一项新举措,并且缺乏加拿大治疗中心的结果数据,我们进行了一个项目评估,以探索治疗中心的效果,并确定可能的改进领域。在逻辑模型的指导下,本评估采用回顾性图表审查。感兴趣的变量包括患者参与、自然精神药物(PRN)的使用、恢复评分、离开单位的时间、私奔、使用约束和隔离以及患者的活动水平。我们评估了这些在治疗中心实施后是否发生了变化。研究结果为治疗中心的积极作用提供了初步证据。病人的参与和离开单位的时间增加了。变化的维持和长期结果仍有待观察;然而,这一评估为我们的法医服务部门继续使用和调查治疗中心提供了支持。
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