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Residential facilities and day centres in mental health. Is there any difference?

Published online by Cambridge University Press:  18 May 2011

Barbara D'Avanzo*
Affiliation:
Unità di Epidemiologia Psichiatria Sociale, Istituto di Ricerche Farmacologiche Mario Negri, Milano
Eugenia Aliprandini
Affiliation:
Dipartimento di Salute Mentale, Azienda Ospedaliera San Carlo, Milano
Massimiliano Beghi
Affiliation:
Clinica Psichiatrica Università di Milano Bicocca, Azienda Ospedaliera San Gerardo, Monza
Cesare Maria Cornaggia
Affiliation:
Clinica Psichiatrica Università di Milano Bicocca, Azienda Ospedaliera San Gerardo, Monza
Arcadio Erlicher
Affiliation:
Dipartimento di Salute Mentale, Azienda Ospedaliera Ca' Granda Niguarda, Milano
Maria Frova
Affiliation:
Dipartimento di Salute Mentale, Azienda Ospedaliera Ca' Granda Niguarda, Milano
Alessandra Mascarini
Affiliation:
Clinica Psichiatrica Università di Milano Bicocca, Azienda Ospedaliera San Gerardo, Monza
Paolo Miragoli
Affiliation:
Dipartimento di Salute Mentale, Azienda Ospedaliera San Carlo, Milano
Augusto Righi
Affiliation:
Dipartimento di Salute Mentale, Azienda Ospedaliera Ca' Granda Niguarda, Milano
*
Address for correspondence: Dr. B. D'Avanzo, Unità di Epidemiologia Psichiatria Sociale, Istituto di Ricerche Farmacologiche Mario Negri, Via La Masa 19, 20156 Milano. Fax: +39-02-39014300 E-mail: [email protected]

Summary

Aims – We wanted to investigate to what extent and in what characteristics the patients cared in the psychiatric residential facilities (RF) were similar to those in the day-centres (DC), and whether 6-month improvements in the two settings were comparable. Methods – We described 141 patients admitted to the RF and 180 in DC of three mental health service networks in Milan and near Milan. They were evaluated again after six months. Results – In both groups, we identified subgroups of more intensive treatment: 45% of those in residential treatment were in high intensity rehabilitation facilities, and those who followed a residential program of >12 hours/week were 53%. The mean duration of treatment in the residential treatment was 40 months (SD 55.7) and in DC 49.6 months (49.3). The two groups differed in the overall scores of the HoNOS, but differences emerged in the subscales relative to daily life activities and living conditions. Among those in RF, about half had a house, versus 99% among those in DC. After six months, clinically significant modifications were small in both groups. Conclusions – Residential patients had more needs than DC patients. It is possible that some of the residential patients might be treated with intensive DC program, but the absence of a home for the majority of residential facilities patients makes this unlikely.

Declaration of Interest: None.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2008

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References

REFERENCES

Auslander, L.A., Lindamer, L.L., Delapena, J., Harless, K., Polichar, D., Patterson, T.L., Zisaak, S. & Jeste, D.V. (2001). A comparison of a community-dwelling older schizophrenia patients by residential status. Ada Psychiatrica Scandinavica 103, 380386.CrossRefGoogle ScholarPubMed
Bollettino Ufficiale della Regione Lombardia, BUR (1998). Definizione di Requisiti e Indicatori per l'Accreditamento delle Strutture Sanitarie, 4° supplemento straordinario al no 35 D.G.R. 6 agosto 1998.Google Scholar
Catty, J., Goddard, K., White, S. & Burns, T. (2005). Social network among users of mental health day care. Predictors of social contact and confiding relationships. Social Psychiatry and Psychiatric Epidemiology 40, 467474.CrossRefGoogle ScholarPubMed
D'Avanzo, B., Battino, R.N., Gallus, S. & Barbato, A. (2004). Factors predicting discharge of patients from community residential facilities: A longitudinal study from Italy. Australian and New Zealand Journal of Psychiatry 38, 619628.CrossRefGoogle ScholarPubMed
de Girolamo, G. & Bassi, M. (2004). Residential facilities as the new scenario of long-term psychiatric care. Current Opinion in Psychiatry 17(4), 275281.CrossRefGoogle Scholar
de Girolamo, G., Picardi, A., Micciolo, R., Falloon, J., Fioritti, A. & Morosini, P. (2002). Residential care in Italy. National survey of non-hospital facilities. British Journal of Psychiatry 181, 220225.CrossRefGoogle ScholarPubMed
Gruppo Nazionale PROGRES (2001). Le strutture residenziali psichiatriche in Italia. I risultati della fase 1 del Progetto PROGRES. Epidemiologia e Psichiatria Sociale 10, 260275.Google Scholar
Leisse, M. & Kallert, T.W. (2003). Normative needs for community-based psychiatric care of patients with schizophrenia in different residential settings. Psychiatry Research 118, 223233.CrossRefGoogle ScholarPubMed
Lora, A., Bai, G., Bianchi, S., Bolongaro, G., Civenti, G., Erlicher, A., Maresca, G., Monzani, E., Panetta, B., Von Morgen, D., Rosi, F., Torri, V. & Morosini, P. (2001). La versione italiana della HoNOS (Health of the Nation Outcome Scale), una scala per la valutazione della gravita e dell'esito nei servizi di salute mentale. Epidemiologia e Psichiatria Sociale 10, 198204.CrossRefGoogle Scholar
Lora, A., Contartese, A., Franco, M., Lo Maglio, M.C., Molteni, E., Pallavicini, A., Rasi, E., Rossini, M., Violanti, E. & Lanzara, D. (2004). L'efficacia nella pratica delle strutture residenziali territoriali: uno studio osservazionale. Epidemiologia e Psichiatria Sociale 13(3), 198208.CrossRefGoogle Scholar
Morosini, P., Magliano, L., Brambilla, L. & Ugolini, S. (2000). Development, reliability and acceptability of a new version of the DSM IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatrica Scandinavica 101, 323329.Google ScholarPubMed
Parabiaghi, A., Barbato, A., D'Avanzo, B., Erlicher, A. & Lora, A. (2005). Assessment of reliable and clinically significant change on HoNOS total score: A longitudinal evaluation in a multicentric routine data collection. Australian and New Zealand Journal of Psychiatry 39, 719725.CrossRefGoogle Scholar
Randolph, F.L., Ridgway, P. & Carling, P.J. (1991). Residential programs for persons with severe mental illness: a nationwide survey of state-affiliated agencies. Hospital and Community Psychiatry 42,11111115.Google ScholarPubMed
Trieman, N. & Leff, J. (2002). Long-term outcome of long-stay psychiatric in-patients considered unsuitable to live in the community. British Journal of Psychiatry 181, 428432.CrossRefGoogle ScholarPubMed
Trieman, N., Smith, H.E., Kendal, R. & Leff, J. (1998). The TAPS Project 41: homes for life? Residential stability five years after hospital discharge. Community Mental Health Journal 34, 407417.CrossRefGoogle ScholarPubMed
Vittorielli, M., Pioli, R., Brambilla, L., Archiati, L., Rossi, G., Sleijpen, C., Magliano, L., Veltro, F., Morosini, P. & Gruppo di Lavoro (2003). Efficacia in riabilitazione psichiatrica dell'approccio VADO: uno studio controllato. Epidemiologia e Psichiatria Sociale 12, 4352.CrossRefGoogle Scholar
Wing, J.K., Beevor, A.S., Curtis, R.H., Park, S.B., Hadden, S. & Burns, A. (1998). Health of the Nation Outcome Scales (HoNOS). Research and development. British Journal of Psychiatry 172, 1118.CrossRefGoogle ScholarPubMed
World Health Organization (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. WHO: Geneva.Google Scholar