Regional New South Wales public hospital coming soon Closing inpatient mental health facilitiesI prefer in-home service.
ABC report Voluntary patients at Kempsey District Hospital will be transferred to a new “home hospital” program or to nearby hospitals, while involuntary patients will be transferred to Port Macquarie Base Hospital, 55km away.
The NSW Government has said the hospital-at-home program could be expanded across the state if it is successful.
Some locals Concerns raised This action, addressing the risks of home care, is the next step in a long process of establishing quality mental health care in our communities.
government Committed to deinstitutionalization Almost 40 years ago, we promised a range of services to help people with mental illness live well in their communities and get the treatment they need.
But these changes have been slow.
Mental health system under financial stress
Our mental health system under great pressure. that Funding Amount Mental health costs account for about 7% of total health care spending, unchanged since 1992.
however burden of disease It is caused by mental health and addiction. Currently, it accounts for approximately 15% of the total disease burden.
Australia’s response to mental illness has shifted to focus on hospitals. Hospital-based spending accounts for the largest share of state and territory spending on mental health. Close to 80%. This type of care is also the most expensive. In other settings, only a fraction of the money is spent on mental health care..
Australia has been a pioneer in hospital alternatives.
Australia has pioneered alternatives to hospitalization for mental illness. As early as 1907, the following community organizations emerged: aftercare association Efforts were being made to find housing, care, and employment for patients in the community outside of the psychiatric hospital.
The 1970s and 80s prompted key questions: Richmond ReportAustralia’s response to mental illness has shifted to providing treatment through a network of services focused on treating and supporting people in the community.
As part of this mix, home hospital models have emerged to provide patients with more options and help manage bed demand. This is now an established mental health care model across Australia.
So what is home hospital for mental health?
Hospital-at-home care provides hospital-level acute mental health care to patients at home without the need for hospitalization.
We provide a similar level of care in a familiar environment. The hospital’s home team, which may include psychiatrists, psychologists, nurses, allied health and peer staff, develops a treatment plan and provides care at home. This may include daily home visits and, in some cases, clinic or online appointments.
The team works with the patient to develop a treatment and recovery plan, often involving family and caregivers with the patient’s permission.
Discharge planning begins from the beginning of hospitalization with the goal of returning the patient to a level of normal functioning in the community as quickly as possible.
What does the evidence say?
The hospital at home Supported by good evidence This is an effective alternative to hospital-based treatment and has been shown to shorten the length of hospital stay and reduce the need for subsequent hospitalization.
Compared to hospital-based care, home clinics also reduce treatment time. risk of side effects Things like isolation and restraint.
Many people think it is more convenient prefer From home to hospital admission. as one person pointed outHome care hospitals:
I felt like I was checked in, not checked in. This is quite a difference. I felt like I was part of a team, not just a number.
There are also customers for whom this type of service is not suitable. People at very high risk of suicide.
Expanding Community Treatment Options
new zealand spending 20% or more The proportion of mental health funding for community-based services is as follows: Australia 7%. New Zealand offers consumers more alternatives to hospital care.
One such service is grow upIt is a consumer-run acute public psychiatric “ward” supported by clinical and specialist staff, but is located in a beautiful home in south Auckland. Tupu Ake reduced the need for acute hospital admissions.
sequence mental health report and inquiry In Australia, we have long encouraged the establishment of a vibrant community mental health sector, including clinics within the home.
However, this choice is still rare. Programs available including: Origen @ HomeServices providing acute mental health care to young people at home are popular but very limited.
Home-based programs require adequate funding.
The unsustainable acute pressures facing hospitals are now forcing health services to urgently consider alternative models of care.
For example, St Vincent’s Health Australia This week’s announcement Over the next five years, we plan to convert half of our services to in-home or online care. The hospital will have a dedicated emergency room and intensive care unit.
It comes as the federal and state/territory governments negotiate over the next five years. Next National Health and Hospitals Funding Agreement.
Alternatives such as hospitals in the home should feature prominently in new funding agreements as part of an overall strategy to reduce the hospital-centric nature of the mental health system.
But to do so, it is important to remain faithful to both the philosophy and model of care that underpins family hospitals for mental health. Replacing suboptimal hospital-based care with suboptimal home care is unacceptable.
