How are Ambulatory Treatment and Personalised Care Being Implemented in Psychiatry? An Analysis of Eight Years of Activity Records of a Belgian Mobile Crisis Team Developed in the Context of the 'Psy 107' Reform.

IF 1.8 4区 医学 Q3 HEALTH POLICY & SERVICES
Sophie Pesesse
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Abstract

Since 2009, the 'Reform 107' has been carrying out a substantial transformation of mental healthcare in Belgium, underpinned by two high ideals: ambulatory treatment and personalised care. Whilst there is broad support for the reform, its implementation is not without its problems and little data exists as to its effects. With that in mind, this article endeavours to assess the care provided by a Brussels-based mobile crisis team. Established by funding generated for the reform, this team has taken these ideals fully on board and, as a crisis response measure providing intensive and short-term care, is playing a central role in the organisation and management of mental healthcare across its territory. Therefore, with an approach at the intersection of the sociology of health and the sociology of public action, this article asks the following question: how are these ambitions- ambulatory treatment and personalised care- enacted in concrete terms in this mobile crisis team's care provision practices? The analysis, based on eight years of activity records of this team, has brought to light that, on the one hand, the care interventions provided and patient referrals, when they occur, are for the most part ambulatory, but that hospitalisations still play a prominent role. On the other hand, this mobile team's care provision is personalised, in particular regarding its duration. It emerges that this duration is correlated with certain individual characteristics, but the analyses nevertheless highlight the presence of other circumstantial determinants, calling for more research to be carried out as to their impact.

精神病学如何实施门诊治疗和个性化护理?“Psy 107”改革背景下比利时移动危机小组8年活动记录分析
自2009年以来,“ 107改革”在比利时开展了精神保健的重大变革,其基础是两大理想:门诊治疗和个性化护理。虽然改革得到了广泛的支持,但其实施并非没有问题,关于其效果的数据也很少。考虑到这一点,本文将努力评估总部位于布鲁塞尔的流动危机小组提供的护理。该小组是由为改革筹集的资金建立的,充分贯彻了这些理想,作为提供密集和短期护理的危机应对措施,在其领土内的精神保健组织和管理中发挥着核心作用。因此,通过健康社会学和公共行动社会学的交叉研究,本文提出了以下问题:流动危机小组的护理实践中,这些目标——门诊治疗和个性化护理——是如何具体实施的?根据该小组8年的活动记录进行的分析表明,一方面,提供的护理干预和病人转诊在大多数情况下是流动的,但住院治疗仍然发挥着重要作用。另一方面,这个流动小组的护理提供是个性化的,特别是在持续时间方面。结果表明,这种持续时间与某些个体特征相关,但分析仍然强调了其他环境决定因素的存在,要求对其影响进行更多的研究。
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来源期刊
CiteScore
5.30
自引率
3.70%
发文量
133
期刊介绍: Community Mental Health Journal focuses on the needs of people experiencing serious forms of psychological distress, as well as the structures established to address those needs. Areas of particular interest include critical examination of current paradigms of diagnosis and treatment, socio-structural determinants of mental health, social hierarchies within the public mental health systems, and the intersection of public mental health programs and social/racial justice and health equity. While this is the journal of the American Association for Community Psychiatry, we welcome manuscripts reflecting research from a range of disciplines on recovery-oriented services, public health policy, clinical delivery systems, advocacy, and emerging and innovative practices.
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