Home Treatment for Acute Psychiatric Care

Psychiatric Services Aargau AG

Status: Completed

Conditions: Mental Disorders

Treatments: Other: Treatment As Usual; Other: Home treatment

Study type: Interventional

Funder types: Other

Identifiers

NCT02322437

PDAG-0001

Details and patient eligibility

About

This study aims to evaluate whether psychiatric home treatment is an effective and efficient alternative to acute inpatient care in mental hospitals. A one-year prevalence cohort of psychiatric patients in need of hospitalization are randomly assigned to either treatment at inpatient wards (treatment as usual) or a new care model with the additional option of treating patients at their homes by mobile care teams. The primary focus is on checking whether optional home treatment leads to a reduction of inpatient days during a two-year follow-up period. In addition, the two service models will be compared regarding treatment cost and outcomes as well as satisfaction of patients and their relatives with psychiatric care.

Furthermore, a sub-cohort of randomly chosen patients from the prevalence-cohort will be examined by a highly trained clinical assessor to test and verify the diagnoses and the clinical ratings made by the staff members of the mental hospital under routine everyday conditions.

Full description

This study aims to evaluate whether psychiatric home treatment is an effective and efficient alternative to acute inpatient care in mental hospitals. A one-year prevalence cohort of psychiatric patients in need of hospitalization are randomly assigned to either treatment at inpatient wards (treatment as usual) or a new care model with the additional option of treating patients at their homes by mobile care teams. The primary focus is on checking whether optional home treatment for crisis intervention leads to a reduction of inpatient days during a two-year follow-up period. In addition, the two service models will be compared regarding treatment cost and outcomes as well as satisfaction of patients and their relatives with psychiatric care.

Furthermore, a sub-cohort of randomly chosen patients from the prevalence-cohort will be examined by a highly trained clinical assessor to test and verify the diagnoses (SCID-I and SCID-II) and the clinical ratings (HoNOS) made by the staff members of the mental hospital under routine everyday conditions.

Enrollment: 707 patients

Sex: All

Ages: 18 to 64 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Need for acute psychiatric inpatient care
• Residence in the canton of Aargau
• Living within 30 minutes (by car) from the headquarters of the home treatment team
• Health insurance with tarifsuisse

Exclusion criteria

• Insufficient proficiency in German
• Main diagnosis F0 or F1 (ICD-10)
• Patients of the forencic departement
• Patients of the child and adolescent department

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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707 participants in 2 patient groups

Home treatment

Experimental group

Description:

Patients in need of acute psychiatric inpatient care are treated at their houses by mobile treatment teams instead of treatment at mental hospitals whenever home treatment is possible and appropriate.

Treatment:

Other: Home treatment

Treatment as usual

Active Comparator group

Description:

Patients in need of acute psychiatric inpatient care are treated at a mental hospital.

Treatment:

Other: Treatment As Usual