[A needs-oriented discharge planning intervention for high utilisers of psychiatric services: quality of the implementation and opportunities for improvement].

OBJECTIVE

Process evaluation of a needs-oriented discharge planning and monitoring (NODPAM) intervention for patients with severe mental illness with high utilisation of inpatient psychiatric care (within a RCT showing lack of evidence of superiority over treatment as usual).

METHODS

Analysis of intervention drop-outs vs. intervention group patients participating in the intervention; analysis of the impact of intervention characteristics on unmet needs over time.

RESULTS

Patients with more severe forms of illness were more likely to be among intervention drop-outs, a relatively high proportion of unmet needs persisted in patients participating in the intervention. Good intervention implementation and high patient satisfaction with the intervention were associated with a reduction of unmet needs.

CONCLUSIONS

The NODPAM intervention failed to reach patients with high service use and more severe forms of illness; quality of intervention implementation might have contributed to the lack of superiority over treatment as usual. The intervention might not have been well integrated in routine treatment and was therefore experienced as extraneous to routine care.