Abstract
In recent years serious mental health issues, such as schizophrenia spectrum disorders and bipolar disorder, have been treated in the community by community-based mental health services. In the present study our goal was to estimate the modification in the number of hospitalizations and duration of admissions in either psychotic patients or patients with bipolar disorder, treated by a Mobile Mental Health Unit in the islands of Kefalonia, Zakynthos and Ithaca (MMHU-KZI). Data were collected from a total of 108 patients with schizophrenia spectrum disorders and bipolar disorder. For each patient comparison was made for the same time interval prior and after engagement to treatment with the MMHU-KZI and not for the total hospitalizations that patients had in their history. There was a statistically significant reduction (45.9%) in hospitalizations after treatment engagement with the MMHU-KZI, as the Wilcoxon signed ranks test indicated. Furthermore, a major decrease (54.5%) of hospitalization days was noted after treatment engagement with the unit. This pattern of mental health provision may be beneficial for the reduction of the number and duration of psychiatric hospitalizations. Despite the beneficial contribution of community-based mental health units, hospital based treatment should always be available, since severe relapses are better treated in inpatient setting.
Highlights
The reform of mental health services has started in many countries during the last decades
Our final sample included 108 patients. 85 of them had been diagnosed with schizophrenia spectrum disorders (F20–F29), and 23 with bipolar disorder (F31)
Even in countries with better mental health resources we find low coverage and poor focusing [2]
Summary
The reform of mental health services has started in many countries during the last decades. For those countries which are more economically developed there is a clear shift from asylum-based services towards the development of community-based services. There are some significant differences between asylum-based services and community-based services. In the asylum-based services social therapeutic activities are minimal or non-existent, while at the same time rehabilitation activities are limited. Social therapeutic and rehabilitation activities play an important role in the treatment plan of community-based services [1]. The community services work towards the creation of a social supportive system, something that is more difficult to happen in asylums
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