Abstract
Abstract Early management of mental health crises is important for a good prognosis and treatment adherence. Ideas have been proposed to address crisis situations at home, aiming to reduce hospitalizations and medication doses and to increase care satisfaction. Identifying experiences of home care for mental health crises can support managers and professionals in proposing innovative practices. This article aims to describe the experience of Trieste, in Italy, which implemented a home crisis team service. The work is carried out in four phases: application of the inclusion criteria for treatment by the crisis team; initial assessment; co-construction of the therapeutic plan; discharge and transition to other services. In one year, the team performed 124 assessments and provided care for 59 people. Regarding psychiatric symptoms, 93% of the patients showed significant improvement at discharge. Considering overall functioning, 81% showed significant improvement. Data show a reduction of compulsory admission rates of 29.4% in the first semester of 2018 and of 78.8% in the second semester, compared to 2017. The home crisis team achieved its goals of holistically caring for suffering individuals and reducing their contact with hospitals.
Highlights
O manejo precoce da crise em saúde mental é importante para bom prognóstico e adesão ao tratamento
A different form of intervention was implemented: death by fire, exorcism, moral treatment, imprisonment, electroshock therapy, lobotomy, and physical and chemical restraint, among others. All these repressive and violent approaches aimed at placating the crisis and returning the person to the standard of normality imposed by society
Any search for transforming the psychiatric paradigm should not be limited to abolishing asylum structures, and include constructing new possibilities in which the actors involved actively participate in all processes of change, deconstructing the concept of normality associated with the established social standard, which defines the parameter between normal and madness
Summary
O manejo precoce da crise em saúde mental é importante para bom prognóstico e adesão ao tratamento. This intensive home care provided by crisis teams to people undergoing psychological suffering has diminished the need for hospitalization in psychiatric services.
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