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Tijdschrift voor Psychiatrie 61 (2019) 5, 317 - 325

Onderzoeksartikel

High and intensive care in long-term inpatient psychiatric services

C.H.C.M. Verbruggen-smulders, D. Postulart, Y. Voskes

background The increase in ambulant healthcare has also led to (simultaneously gained) insights that possibilities for temporary hospitalisation/admittance should be available for patients who experience a serious mental crisis. Based on experiences gained from the projects ‘Reducing Coercion’, high and intensive care (hic) has been developed. hic aims to improve care for psychiatric patients who are in need of crisis admission in a psychiatric hospital.
aim To investigate whether the hic model is applicable to patients staying at a long-term psychiatric unit in hospital who, due to a severe psychiatric crisis, need to be hospitalised short-term in an emergency department of long-term inpatient care.
method A responsive process evaluation in which three emergency departments with inpatient healthcare (from three different psychiatric institutions) participated. Starting point was application of the hic evaluator, followed by semi-structured interviews and focus groups.
results The items as described in the hic manual could be implemented within this setting. Stimulating and impeding factors were found, as well as adjustments needed to remove barriers to successful implementation.
conclusion Although the hic model can be applied to the crisis departments of long-term inpatient psychiatric services, adjustments are indicated.

keywords crisis intervention, high and intensive care, hospitalised mental healthcare, pressure and coercion