["I Indeed Consider it to be a Temporary Solution" - A Qualitative Analysis of the Conditions and Obstacles to Implementation of Psychiatric Home-Treatment in Berlin and Brandenburg].

OBJECTIVE

The obstacles to implementation of a German variation of psychiatric Home-Treatment (HT), called "Inpatient Equivalent Home-Treatment" (IEHT) are examined.

METHOD

43 employees from 11 psychiatric hospitals in the federal states of Berlin and Brandenburg were questioned using interviews and focus groups. A thematic analysis was conducted using the socio-institutional theoretical model.

RESULTS

At system-level, implementation is hampered by an inadequate service definition, staff shortages, as well as performance assessments by health insurances. This leads to reluctant implementation at hospital-level with insufficient staffing of the teams. Other barriers include a lack of mobile devices for documentation and team communication. At the level of employees, poor information, and cooperation as well as unclear assignment of tasks are impeding factors.

CONCLUSION

For a more needs-oriented, flexible, and nationwide introduction of HT according to IEHT, improvements to the underlying framework conditions and further research addressing efficacy, effectiveness and implementation are necessary.