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街头心理健康护理:综合方法。

Mental health care on the streets: An integrated approach.

机构信息

Monash Alfred Psychiatry Research Centre, Monash University and The Alfred, Prahran, Vic., Australia.

出版信息

Aust N Z J Psychiatry. 2010 Jun;44(6):505-12. doi: 10.3109/00048670903555120.


DOI:10.3109/00048670903555120
PMID:20482410
Abstract

BACKGROUND: Mental illness can be both a cause of and a reaction to being homeless. When homelessness co-exists with mental illness, the provision of care for very vulnerable people is significantly complicated. Our initiative built on a model of assertive outreach and embedded mental health staff into the daily operations of Hanover Welfare Services and Sacred Heart Mission welfare services in inner Melbourne. The initiative's aim was to facilitate closer collaboration between mental health and welfare services and develop staff capacity to better identify and support people living homeless with a mental illness. METHOD: The project involved studying the impact of our assertive outreach model on consumer and service outcomes. Demographic, clinical and service usage details for consumers engaged by the initiative were recorded. Changes to the rate of admission of people from both welfare services to The Alfred Inpatient Psychiatry Unit and requests for support from The Alfred Crisis Assessment and Treatment Service were also recorded. RESULTS: People engaged by this initiative had high levels of previous emergency medical or psychiatric service usage, but relatively low levels of current community mental health engagement. There were also high levels (almost 52%) of comorbid substance misuse. The initiative was, however, able to engage more people in ongoing community mental health care, which particularly when provided in collaboration between mental health and welfare staff, achieved improvements in accommodation stability. The initiative also resulted in improved identification and prevention of mental illness crises through supporting a more rapid onsite mental health response. CONCLUSIONS: Embedding mental health staff into the daily operations of two welfare services in inner Melbourne improved inter-service collaboration and the identification and care for people living homeless with a mental illness.

摘要

背景:精神疾病既可能是导致无家可归的原因,也可能是无家可归的反应。当无家可归与精神疾病并存时,为非常脆弱的人提供护理的工作会变得异常复杂。我们的倡议是在积极外展模式的基础上建立的,将精神卫生工作人员嵌入到汉诺威福利服务(Hanover Welfare Services)和墨尔本内城圣心使命福利服务(Sacred Heart Mission welfare services)的日常运营中。该倡议的目的是促进精神卫生和福利服务之间更紧密的合作,并提高工作人员的能力,以便更好地识别和支持无家可归且患有精神疾病的人。

方法:该项目研究了我们的积极外展模式对消费者和服务结果的影响。记录了参与该倡议的消费者的人口统计学、临床和服务使用详细信息。还记录了这两个福利服务机构的入院率以及向阿尔弗雷德住院精神病学病房(The Alfred Inpatient Psychiatry Unit)和阿尔弗雷德危机评估和治疗服务(The Alfred Crisis Assessment and Treatment Service)请求支持的变化。

结果:参与该倡议的人之前曾大量使用急诊医疗或精神科服务,但目前参与社区精神卫生服务的程度相对较低。同时也存在较高水平的共病物质滥用(近 52%)。然而,该倡议能够使更多的人参与到持续的社区精神卫生保健中,特别是当精神卫生和福利工作人员之间进行合作时,这在稳定住宿方面取得了改善。该倡议还通过支持更快速的现场精神卫生反应,提高了对精神疾病危机的识别和预防能力。

结论:将精神卫生工作人员嵌入到墨尔本内城的两个福利服务的日常运营中,改善了服务之间的合作以及对无家可归且患有精神疾病的人的识别和护理。

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引用本文的文献

[1]
A systematic review and meta-analysis of the prevalence of alcohol and other drug use and problematic use among people accessing mental health treatment in Australia.

Aust N Z J Psychiatry. 2025-4

[2]
Care Coordination Can Reduce Unmet Needs of Persons With Severe and Persistent Mental Illness.

Front Psychiatry. 2019-8-9

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