scholarly journals Improve Sustainable Housing for People with Severe Mental and Drug Disorders. An Intervention Analysis of the Home-Treatment Service Providers in Vorarlberg/Austria

2019 ◽  
Vol 07 (04) ◽  
pp. 396-412
Author(s):  
Nikolaus Blatter ◽  
Harald Rudolf Bliem ◽  
Silvia Blatter
2010 ◽  
Vol 34 (3) ◽  
pp. 262 ◽  
Author(s):  
Rachel Canaway ◽  
Monika Merkes

This paper draws from a literature review commissioned as part of a larger project evaluating comorbidity treatment service models, which was funded by the Australian Government Department of Health and Ageing as part of the National Comorbidity Initiative. The co-occurrence of mental health and substance use disorders (comorbidity) is a common and complex problem. This paper outlines conceptual and practical complexities and barriers associated with comorbidity treatment service delivery, particularly around the variable nature of comorbidity, and the impacts of the separation of the mental health (MH) and alcohol and other drug (AOD) sectors with their differing institutional cultures, aetiological concepts, philosophical underpinnings, educational requirements, administrative arrangements, and screening and treatment approaches. Issues pertaining to the lack of consistent definitions and conceptual frameworks for comorbidity are discussed, particularly in relation to the reported lack of communication, collaboration, and linkages between the sectors. It is suggested that the adoption of consistent terminology and conceptual frameworks may provide a valuable step towards consistency in service provision and research and could lead to improved capacity to address the many issues relating to comorbidity service provision and treatment efficacy. What is known about the topic?The co-occurrence of mental health and substance use disorders (comorbidity) is a common and complex problem. However, the service system is not sufficiently developed and coordinated to serve clients with comorbid problems well. What does this paper add?This paper summarises the issues pertaining to conceptual and practical complexities and barriers associated with comorbidity treatment service delivery, including the different aetiologies of comorbidity and types and settings of service providers. What are the implications for practitioners?There is a need for practitioners and other stakeholders to agree on consistent terminology and framework(s) relevant to comorbidity to overcome the barriers and complexities that currently limit service delivery and access to treatment.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Kirsten Marchand ◽  
Corinne Tallon ◽  
Christina Katan ◽  
Jill Fairbank ◽  
Oonagh Fogarty ◽  
...  

Abstract Background Opioid use is one of the most critical public health issues as highly potent opioids contribute to rising rates of accidental opioid-related toxicity deaths. This crisis has affected people from all age groups, including youth (ages 15–24) who are in a critical developmental period where the stakes of opioid use are especially high. Efforts to reduce the significant harms of opioid use have focused on the expansion of evidence-based treatments, including medications for opioid use disorder (e.g. buprenorphine). While these treatments are unequivocally life saving, recent evidence suggests that they may not align with youths’ needs. Accordingly, the ‘Improving Treatment Together’ (ITT) project has been designed with the aim to improve youths’ opioid treatment service experiences and outcomes by co-developing, implementing, and measuring youth-centred opioid use treatment service innovations. This manuscript describes the protocol for this multi-phase project. Methods The ITT project follows community-based participatory research (CBPR) and strategically integrates co-design processes throughout its four phases. Upon establishing a project partnership between national, provincial and community-based organizations, Phase 1 follows four core elements of human-centred co-design (empathy, needs identification, ideation, prototyping) in nine separate workshops. These workshops will be held in four diverse communities with youth, caregivers and service providers who have accessed or delivered opioid treatment services. Phase 1 will culminate in the co-production of opioid treatment service innovations to be considered by the project’s partners for further co-development, pilot testing, and wider implementation during the remaining phases of the project. Throughout each phase, the project will collect and analyse both qualitative and quantitative research and evaluation data to determine the project’s impact. Discussion This protocol provides a detailed description of the ITT project, with an emphasis on the project’s application of co-design and CBPR processes, the planned research and implementation procedures, and the establishment of a unique partnership. To our knowledge, this is one of the first projects to integrate these participatory processes to the design, implementation and measurement of youth-centred opioid treatment services. Embedding these processes throughout each phase of the project will strengthen the relevance and feasibility of the project’s service delivery innovations.


2001 ◽  
Vol 25 (8) ◽  
pp. 310-313 ◽  
Author(s):  
Judy Harrison ◽  
Nooreen Alam ◽  
John Marshall

Aims and MethodHome treatment offers an alternative to in-patient care, but little has been written about the practicalities of running such a service. Using routine information sources, details of referral and outcome are presented for patients assessed by a home treatment service over 6 months.ResultsForty-eight per cent of referrals were not accepted, mainly because of lack of cooperation, risk to self or others or the illness not being acute enough. Referrals from junior doctors and accident & emergency were least likely to be accepted. Seventy-two per cent of patients accepted suffered from schizophrenia, bipolar affective disorder or depression with psychosis, similar to the diagnoses for in-patients. Twenty per cent of patients accepted had to be transferred to in-patient care later.Clinical ImplicationsStaffing levels need to take account of time spent assessing patients. Junior doctors need training in how to use home treatment services appropriately and a wider range of options are needed to manage patients in crisis out of hours. It is possible to target patients with severe mental illness in a home treatment setting, but a significant number will need transfer to inpatient care.


2008 ◽  
Vol 32 (11) ◽  
pp. 438-438
Author(s):  
Claire Dibben ◽  
Humera Saeed ◽  
Konstantinos Stagias ◽  
Golam Mohammed Khandaker ◽  
Judy Sasha Rubinsztein

1989 ◽  
Vol 13 (12) ◽  
pp. 667-669 ◽  
Author(s):  
Christine Dean ◽  
Elaine Gadd

Over the last ten years it has been shown that it is possible to treat the majority of patients with acute psychiatric illness in their own homes. Home treatment has been shown to produce a superior outcome to hospital care on measures of symptomatology, subsequent independent living and employment status (Hoult, 1986) self-esteem (Stein & Test, 1980) and may decrease the need for re-admission. Additionally, home treatment decreases the burden felt by the relatives (Pai & Kapur, 1982) and may enable them to cope better with the patient after the acute episode.


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