Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, OX3 7JX, UK.
Centre for Psychiatry, Wolfson Institute for Preventative Medicine, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK.
Community Ment Health J. 2021 May;57(4):753-763. doi: 10.1007/s10597-020-00694-5. Epub 2020 Aug 1.
The traditional model of psychiatric assessment and diagnosis can be criticised as reductive. We developed an innovative model for psychiatric assessment of adult patients referred to our adult mental health team, the Systemic Assessment Clinic, incorporating the principles and techniques of systemic family therapy and dialogical practice into standard psychiatric assessment. We conducted a service evaluation, comparing prospective use of mental health services for patients assessed either in the Systemic Assessment Clinic or in standard assessment. Patients assessed in the Systemic Assessment Clinic had more favourable outcomes than those in standard assessment: they were significantly less likely to need multiple follow-up treatment appointments with a psychiatrist and to be re-referred to mental health services once discharged, indicating reduced healthcare costs. Satisfaction rates for participants attending the systemic assessment clinic were high. Our service evaluation gives preliminary evidence that the Systemic Assessment Clinic could be a potential new model for psychiatric assessment; further evaluation is warranted in a randomised controlled trial.
传统的精神科评估和诊断模式可能被批评为过于简化。我们为转介至我们成人心理健康团队的成年患者开发了一种新的精神科评估模式,即系统评估诊所,将系统家庭治疗和对话实践的原则和技术纳入标准的精神科评估中。我们进行了一项服务评估,比较了在系统评估诊所或标准评估中接受评估的患者对精神卫生服务的前瞻性使用情况。在系统评估诊所接受评估的患者比在标准评估中接受评估的患者有更好的结果:他们明显不太可能需要多次与精神科医生进行后续治疗预约,并且一旦出院就不太可能再次转介到精神卫生服务,这表明医疗费用降低。参加系统评估诊所的参与者的满意度很高。我们的服务评估初步证明,系统评估诊所可能是一种新的精神科评估模式;需要在随机对照试验中进一步评估。