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Home Treatment for Acute Mental Healthcare: Who Benefits Most?

Community Mental Health Journal volume 57, pages 828–835 (2021)Cite this article

Abstract

Home treatment (HT) has been proposed as an alternative to inpatient treatment for individuals in acute mental crises. However, there is limited evidence concerning the effectiveness of HT to date. The aim of this study was to investigate which patients benefit most from HT. The concept and utilization of two HT services in Switzerland were retrospectively compared based on routine medical data of all patients who were treated in one of the two HT services between July 2016 and December 2017. We examined which patient characteristics were related to successful replacement of hospital care by HT based on a calculated success score using binary regression analyses. The whole sample included 408 individuals with an average age of 43 years and of whom 68% were female. As a result of conceptual similarities, in both HT settings, the typical patient was middle-aged, female and having an affective disorder as the main diagnosis. Half of the treatment cases met the criteria of successful replacement of hospital care (> 50% of the total treatment episodes in HT, treatment duration < 40 days and treatment terminated by mutual agreement). The results of the regression analyses indicated that patients with a lower symptom severity at admission (lower HoNOS score) and those who were employed had more likely a successful replacement of hospital care.The findings suggest that patients with acute mental disorders who have a certain level of functioning and social support might benefit most from HT in the sense of successful replacement of hospital care.

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Affiliations

  1. Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland

    Sonja Mötteli, Stefan Vetter & Erich Seifritz

  2. Psychiatrie Baselland, Liestal, Switzerland

    Matthias Jäger

  3. Integrated Psychiatric Services Winterthur – Zurcher Unterland, Winterthur, Switzerland

    Urs Hepp & Niklaus Stulz

  4. Psychiatric Services Aargau AG, Königsfelden, Switzerland

    Lea Wyder

Authors
  1. Sonja Mötteli
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  2. Matthias Jäger
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  3. Urs Hepp
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  4. Lea Wyder
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  5. Stefan Vetter
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  6. Erich Seifritz
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  7. Niklaus Stulz
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Contributions

SM, NS, MJ contributed to the conception and design of the study; SM, NS and LW organized the database, SM performed statistical analysis; SM wrote the first draft of the manuscript; NS, MJ, UH, SV, LW and ES contributed to the manuscript revisions and approved the submitted version.

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Correspondence to Sonja Mötteli.

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The authors declare that research was conducted without the presence of any personal, professional or financial relationships that could potentially be a conflict of interest.

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Mötteli, S., Jäger, M., Hepp, U. et al. Home Treatment for Acute Mental Healthcare: Who Benefits Most?. Community Ment Health J 57, 828–835 (2021). https://doi.org/10.1007/s10597-020-00618-3

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  • DOI: https://doi.org/10.1007/s10597-020-00618-3

Keywords

  • Home treatment
  • Acute psychiatric care
  • Crisis
  • Outreach services
  • Mental health services