Mezzina R, Vidoni D
Centro di Salute Mentale, Trieste, Italy.
Int J Soc Psychiatry. 1995 Spring;41(1):1-20. doi: 10.1177/002076409504100101.
A sample group of 39 new patients with acute and severe crises underwent a 4-year follow-up study at the community mental health center in Trieste (CMHC). The CMHC is a full-time service, open 24 hours a day and 7 days a week, and is fully integrated into a network of services which has completely replaced the preexisting mental hospital. Evaluation shows: 1) a generally good outcome of the initial crisis; 2) a low relapse rate; 3) a tendency towards favourable long-term outcomes. In terms of practice, voluntary and compulsory hospitalization were avoided in favor of short-term day and night support in the CMHC. There were no suicides, no crimes, no drop-outs. Social adjustment remained unchanged. Accessibility and continuity of care were favored by not separating special crisis services. Instead, crisis intervention was integrated into a comprehensive Mental Health Service offering a wide range of preventive and rehabilitative responses. The study demonstrates that the mental health services in Trieste are able to cope with acute crises without psychiatric hospitalization.
一组由39名患有急性严重危机的新患者组成的样本，在的里雅斯特社区心理健康中心（CMHC）进行了为期4年的随访研究。CMHC是一项全日制服务，每周7天、每天24小时开放，并且完全融入了一个服务网络，该网络已完全取代了原有的精神病院。评估显示：1）初始危机的总体结果良好；2）复发率低；3）有长期良好结果的趋势。在实践方面，避免了自愿和强制住院，转而在CMHC提供短期的日间和夜间支持。没有自杀事件、没有犯罪行为、没有患者退出。社会适应情况保持不变。不将特殊危机服务分开，有利于提高服务的可及性和连续性。相反，危机干预被纳入了一项全面的心理健康服务，该服务提供广泛的预防和康复应对措施。该研究表明，的里雅斯特的心理健康服务机构能够在不进行精神病住院治疗的情况下应对急性危机。
