[The home visit--a study of ambulatory management of psychiatric patients within the scope of 2 mobile outpatient services].

Domiciliary visiting and follow-up care of mentally ill patients is one of the foci of treatment-and-care activities of a mobile outpatient care unit working in social psychiatry. Its self-declared aim is to either avoid or to cut down inpatient treatment or reference to a psychiatric hospital or asylum, and thus to enable the patient to lead a life of greater freedom and fewer restrictions. 217 home visits by members of two psychiatric mobile outpatient care units were evaluated and analysed via a descriptive and differentiated questionnaire study. The analysis revealed that patients themselves had requested a visit in only 12.4% of the cases. This seems to be a characteristic feature of psychiatric care. Another striking factor is the mediation by a "third person", for in almost 40% of all the cases the initiative came from relatives, neighbours, the family doctor, the police, the welfare office, the landlord and others, showing how closely follow-up care is interlinked with the patient's social environment. The style of working of the psychiatric care unit is reflected by the varied participation of representatives of different professions in the home visiting service. It is also remarkable that in 31 patients (i.e. 18% of the home visits) the home visit established the first contact between therapist and patient. Whenever such an initial contact was accomplished, the home visit always had a triadic structure. It is a direct consequence of our study that the members of a mobile psychiatric care service should boldly tackle the problems of basic concepts regarding the position and status of the individual within the system of psychiatric and welfare care.