Case management for Psychiatric Patients with Psychotic Symptoms

Abstract

People with mental illness often lacks the insight and refuses to take the drug. The case management as an approach to caring for mentally ill people in the community is effective. Psychiatric home care is composed of psychiatrists, nurses, social workers and occupational therapist. The psychiatric home care nurse is the case manager, responsible for the formulation, revision and evaluation of the care plan. Telephone consultation and two times home visit per month, case seminars for difficult cases, including family members in the treatment alliance, improve patients were assisted to the compliance of medication and treatment, and promote psychological support between patients and their families. To improve patient problem-solving skills and self-discipline and disease management capabilities, provide social resources or referral to rehabilitation agencies as needed, conduct crisis management for special situations, assist patients to return or re-admit if necessary, and maintain continuous quality Indicator monitoring. Case management was worked on three main indices: (i) numbers remaining in contact with the psychiatric services; (ii) extent of psychiatric hospital admissions; and(iii) clinical outcome of Brief Psychiatric Rating Scale (BPRS). After one year of home care from January to December 2015, 102 cases were inclued, and scores on Brief Psychiatric Rating Scale (BPRS) were significantly lower (28.43 ± 5.71 to 24.13 ± 4.45; t = 8.509, p ＜ 0.01); re-hospitalization rates were 16.7% (17/102), and satisfactions were 98.0% (100 /102). The results confirmed that home care can help patients with stable, increase self disease management, effectively reduce the rate of re-residence, and achieve the goal of stable patient life in the community.