Impact of a psychiatric outreach service for homeless persons with schizophrenia
ABSTRACT Since 1988 a 24-hour psychiatric out reach service has been in operation in the inner city of Sydney to provide services to residents of refuges for the homeless. A total of 506 homeless persons with schizophrenia were referred to the outreach service between April 1988 and mid-1992, of whom 91 failed to attend. Hospitalization data were collected for the four years before and the four years after each individual's referral to the service. After the introduction of the service, the rate and duration of psychiatric hospital admissions for residents with schizophrenia who were treated by the outreach service decreased significantly, whereas those who failed to attend showed no such decrease.
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- "Longitudinal planning assumes that the long-term needs of clients are accounted for. Recent research suggests the need for public psychiatric beds (Bachrach, 1981, 1986; Buhrich & Tesson, 1996; Fisher, 1994; Hogarty, 1993; Munich & Lang, 1993). "
ABSTRACT: A longitudinally based discharge planning and treatment model that integrates essential components of other successful approaches (PACT, PACED, and Bridge to Discharge) is described. The development of linkages between the inpatient and community mental health providers during the early stages of hospitalization could improve the continuity of care and establish an aftercare plan rooted in existing community resources. Placing the client's need first will ensure a smoother transition from the structure of the inpatient ward to the community while maintaining continuity of care and reducing potential re-admissions to the hospital. Potential barriers that may prevent the adoption and implementation of such a system are discussed. Belcher and DeForge (2005) in Part 1 provided a review of case management and discharge planning, as well as a critique of case management models. In Part 2, DeForge and Belcher (2005) present and describe the components of the longitudinally based discharge planning and treatment model (LDPTM).Social Work in Mental Health 07/2005; 3(4):33-61. DOI:10.1300/J200v03n04_03
- "This model of treatment is based on the assertive community treatment approach to psychotic disorders which has been found to be superior to other models such as intensive case management (Issakidis, Sanderson, Teesson, Johnston, & Buhrich, 1999; Marshall & Lockwood, 2002; Rosen & Teesson, 2001). Even in a group as comorbid as the homeless, psychiatric outreach services based on assertive case management have been found to be effective in Australia (Buhrich & Teesson, 1996). "
Article: Comorbidity and delivery of services
Article: Management of comorbidity[Show abstract] [Hide abstract]
ABSTRACT: Comorbidity of substance use disorders and mental disorders is very common, and there is substantial heterogeneity within subgroups in terms of both their characteristics and the nature of causal relationships between the disorders. Assessment and management strategies need to deal with both the size of the problem across the community and its severe impact in some subgroups, including those with psychosis. At this stage, the research base from which we can derive recommendations is very narrow, but it does offer a foundation for preliminary conclusions. This chapter reviews the current evidence and makes some suggestions for assessment and for both psychological and pharmacological management.