To explore criteria evaluating the effectiveness of psychiatric home care-mobile team practices, that have been developed widely in the last decades.
Systematic review of the literature.
We included ...24 studies published between January 2010 and October 2023.
CINAHL, APA PsycInfo, Embase, Scopus and PubMed.
The evaluation criteria differed according to the studies: impact on hospital stay, symptomatic clinical impact, repercussions on functioning, quality of life, analysis of profitability, safety, therapeutic alliance and finally, cooperation network.
The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices shows their richness and diversity, and the absence of standardisation.
The variability of the criteria used to judge the effectiveness of psychiatric home care-mobile team practices supports a qualitative and multidisciplinary approach, with enhanced teamwork.
Psychiatric home care-mobile team practice have widely developed in the last years and their effectiveness need to be evaluated. Our main finding is that there is a rich variety of practices and that evaluation criteria are very diverse, thus not standardised. We suggest using a mixed-method approach to capture the subjective experience of patients and caregivers. These findings also highlight the significance of institutional cooperative work and call for a redefinition of team construction.
The authors adhered to PRISMA guidelines.
No patient or public contribution.
At the time of “ambulatory shift”, new modes of care are developing: this is the case of the mobile teams of physical and rehabilitation medicine (PRM) LJ1 who participate in diversification of ...health care facilities. They concern disability (whatever its origin) and actions for short or medium stay, links between private and hospital practice, medico-social, care pathway and the absence of breach for this complex patient.
The objective is to encourage out of hospital care, as far as possible, in all actions waged.
Our mobile team “EMT3R 69” (territorial mobile team of rehabilitation, reintegration) is multidisciplinary (Physician PRM, occupational therapist, physiotherapist, social worker) and was created in January 2017. It is funded by the regional health agency “ARS” for a period of 3 years.
Application for Team's intervention must contain specific objectives. A rapid response is provided in order to found the most appropriate response.
After 1 year experience, 121 persons (58% of men) were included corresponding to 682 interventions, among which 193 in the living place. Other interventions comprised follow-up to the recommendations, coordination with the partners,…). Patients were heavily dependent (RANKIN 4), mainly neurologically disabled (92%), living at home (66.8%) or in a medico-social institution (27.4%). Sixty-eight percent benefited from information/recommendations on technical assistance of all types, 33% were helped/oriented in administrative procedures related to disability and 29% were redirected to medical professionals or other adapted structures.
The creation of this team (and 6 other ones in Rhône-Alpes) allows responding to several priorities of public health: “facilitate access to an adapted and efficient healthcare offer”, “make care pathway more fluid”. After more than a year of experience, improvement will be set up particularly in supporting caregivers and then in terms of territorial coverage and network development.
Georgia has recently made a commendable effort to reform mental health care. The Concept on Mental Health Care adopted by the Government and the two strategic plans for 20142020 and 20212031, which ...aimed to develop comprehensive evidence-based, culturally appropriate, and human rights-oriented mental health care, have promoted the deinstitutionalization and development of community mental health services. Since 2018, new standards of care for mental health ambulatories and mobile teams have been imposed and implemented in the state programme and funded accordingly. The study aimed to investigate the quality of care in community mental health services. As a result, we monitored the mental health ambulatories in all major cities and regional centres of the country (in total, 16 ambulatories) and the mobile teams which had at least two years of experience (in total, 14 mobile teams). The data analyses showed that the new standards for ambulatories and mobile teams increased access to and coverage of mental health care across the country. However, further effort is still needed to achieve comprehensive treatment by mental health care services.
Many elderly people live well and at home, but some require somatic and psychiatric care. Mobile psychiatric teams for the elderly are called upon to intervene with people aged 65-70 and over who are ...experiencing psychological distress. Among senior citizens, addictive disorders are very common, and are associated with psychiatric and geriatric co-morbidities. Alcohol, tobacco and benzodiazepine use disorders require holistic, individualized care, based on identification, prevention and referral, as well as training and coordination of professionals and caregivers.
Collaboration across hospital-primary-community healthcare continuum is crucial to ensuring secure medication management at home, particularly among elderly persons. The study aim was to describe ...older adult’s experiences of medication assessment using Safe Medication Assessment (SMA) in connection to home visits. A study was conducted, with data from 44 participants analyzed through qualitative content analysis (semi-structured interviews) at baseline, 1-month, and 3-month follow-ups based on SMA’s 20 items. The results include 1 theme “Personcentredness due to medication management,” and 2 categories, “Systematic approach towards safe medication at home” and “Taking control over prescribed drugs.” SMA ensures a systematic work approach during home visits conducted by mobile team units, working in partnership with all involved parties (elderly, care providers, relatives) improving safe medication management at home.
Au mois de mars 2020 l’ensemble de l’Hôpital d’Instruction des Armées Bégin a été réorganisé pour faire face à l’épidémie de COVID-19. Le service de psychiatrie de l’hôpital a été sollicité par les ...chefs de certains services pour prévenir l’épuisement professionnel en proposant un soutien psychologique au plus près des équipes mobilisées. Un dispositif original et innovant a ainsi été mis en place et s’est pérennisé au fil des vagues successives sous le nom d’« équipe mobile de soutien psychologique », incluant psychiatres, psychologues et infirmiers du service de psychiatrie. Ce dispositif sur mesure s’inspire de l’expérience opérationnelle du service de santé des Armées : il s’agit d’une pratique de l’informel à l’image de la pratique des psychiatres en OPEX. Cette pratique en situation implique de se greffer sur la vie des services, afin de susciter la demande et d’aborder le groupe de façon progressive. Intervenir en situation de crise invite à réfléchir le soutien du groupe autour de plusieurs axes : l’idéal commun qui porte ses membres et les manifestations psychopathologiques collectives. Le groupe est un rempart que l’équipe mobile doit approcher avec subtilité afin de faire circuler la parole entre pairs et mobiliser sa fonction de soutien tout en respectant les défenses, mais aussi les enjeux éthiques qu’une telle pratique en situation de crise peut induire.
In March 2020, the entire Begin army hospital was reorganised to deal with the COVID-19 epidemic. The hospital's psychiatry unit was requested by the heads of some services in order to prevent professional exhaustion by offering psychological support as close as possible of the mobilised teams. An original and innovating device named “psychological support mobile team” was set up and has been perpetuated over the successive waves. It has been including psychiatrists, psychologists and nurses of the psychiatry unit. This customised set up inspires itself of operational experience of the french army health service (SSA). This situational practice implies to graft on the service's life. It aims is to stimulate demand and to approach the group gradually. Responding to crisis situations invites us to reflect the group's support around several axes: the common ideal that carries its members and the collective psychopathological demonstrations. The group is a rampart that the mobile team has to approach with subtlety in order to circulating speech between peers and to mobilise its support function. The mobile team also has to be attentive to the ethical issues that such a pratice in a health crisis situation can induce.
The "transitional mobile team" has been developed to optimize the management of the transition from prison to the community for people with psychiatric disorders in France. The objectives are to ...limit the risk of relapse and death during this high-risk period and to ensure the links between psychiatry in prison and community psychiatry.
EMI-ECO est une équipe mobile intervenant auprès des enfants âgés de moins de 12 ans confiés à l’aide sociale à l’enfance et qui a pour but un repérage/une évaluation des troubles du développement ou ...des troubles mentaux, une organisation des soins pour ces enfants mais aussi un travail partenarial avec l’ensemble des équipes prenant en charge ces jeunes (aide sociale a l’enfance, protection maternelle et infantile, Centre médico-psychologique/Centre médico-psycho-pédagogique). Les interventions sont intersectorielles dans une aire géographique correspondant aux intersecteurs de deux hôpitaux ayant créé l’équipe (AP–HM et CHS Valvert) soit le sud et l’est de Marseille, la Ciotat, Aubagne et Cassis. Ce territoire a été défini pour être cohérent et permettre une meilleure efficacité des interventions. Dans ce travail, nous présentons la mise en place et les premiers éléments d’activité d’un dispositif innovant, à savoir une équipe mobile intervenant au plus près du lieu de vie et dans l’écosystème des enfants confiés à l’aide sociale à l’enfance. Nous illustrerons également nos propos à travers deux cas cliniques d’enfants pris en charge par notre unité. La prise en charge de ces enfants implique un investissement réel du professionnel et un important travail de collaboration. Nous espérons que la présentation de notre dispositif permettra à d’autres équipes de s’en saisir et de l’adapter aux particularités de leur terrain d’intervention.
EMI-ECO is a mobile team working with children under the age of 12 entrusted to the Children's Social Welfare Agency (Aide Sociale à l’Enfance). Its aim is to identify and assess developmental or mental disorders, organize care for these children and work in partnership with all the teams caring for these youngsters (Child Welfare Agency, Maternal and Child Protection, Centre médico-psychologique/Centre médico-psycho pédagogique). Intervention takes place across a geographical area corresponding to the intersectors of the two hospitals that created the team (AP–HM and CHS Valvert), i.e. the south and east of Marseille, La Ciotat, Aubagne and Cassis. This territory was defined to be coherent and to enable more effective interventions. In this work, we present the implementation and initial results of an innovative system, namely a mobile team working as close as possible to the living environment and ecosystem of children entrusted to the child welfare system. We will also illustrate our remarks with two clinical cases of children cared for by our unit. Caring for these children involves a real investment on the part of the professional and a major partnership effort. We hope that the presentation of our system will enable other teams to adopt it and adapt it to the particularities of their field of intervention.
Provision of mobile care at the home of patients appears to become necessary as the population becomes increasingly older. But there are challenges in moving emergency care from hospitals to the home ...of patients. The aim of the study was therefore to describe the experiences of the mobile care in Sweden.
Semi structured interviews were conducted with 12 persons with experience of mobile care in Sweden, such as nurses, physicians, civil servants and politicians. Qualitative latent content analysis was used as an analysis method.
The results show that cooperation is of utmost importance to achieve functioning mobile care. Cooperation both on an inter-organizational level and on a close team-work is required for all of the involved parties in mobile care to take on a joint responsibility for the patient. As mobile care is primarily provided to elderly multimorbid patients, a comprehensive view on patient care is required in which the patient and their relatives experience security.
Mobile care is seen as a moving care that comes to the seeking person and not the other way around. The resources are distributed where they make the most use, that is, closest to the individual. Mobile care is seen as a complement to the traditional hospital care. This means a different way of working that requires close collaboration between different categories of personnel and organizations, where there should not be any discussions about boundaries, rather, the discussion should include patient's needs and situation instead.
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